This article appears in the following Rheumatology issue: Ten years of partnership: translating ideas into progress in systemic sclerosis [View the issue table of contents]
Reviews |
The complexity of managing systemic sclerosis: screening and diagnosis
1Department of Biomedicine, Centre DenoThe, Division of Rheumatology, AOUC University of Florence, Florence, Italy, 2Department of Medicine, Georgetown University, Washington DC, USA, 3Rheumatology Research Unit, Sunshine Coast Queensland Department of Medicine, University of Queensland, Queensland, Australia and 4Hôpital Claude-Huriez, University of Lille, Lille, France.
Correspondence to: M. Matucci-Cerinic, Department of Biomedicine, Centre DenoThe, Division of Rheumatology, AOUC University of Florence, Florence 50139, Italy. E-mail: cerinic{at}unifi.it
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Abstract |
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The difficulties inherent in diagnosing, screening and treating SSc are reflected by the complex pathology of the disease, which involves the development of severe organ-based complications that reduce both quality of life and overall survival. Early detection and prompt treatment of such complications depend upon a successful and timely screening strategy, which, in turn, requires cooperation between disciplines and good collaborative links at all stages of the disease. Establishment of a disease registry for SSc may also be of benefit, as such registries facilitate longitudinal observation of trends in disease presentation, management and outcome. They may also help to determine potential risk factors and identify those patient subgroups that face the highest risk of developing disease. In patients with known or suspected SSc, a panel of disease-specific markers—such as autoantibodies, cell activation markers and markers of organ involvement—may help to establish the diagnosis and assess prognosis; however, changes in serum levels of such markers throughout the course of SSc should be interpreted with caution, as they may not always correlate with disease activity. Nail-fold capillaroscopy is a promising tool for SSc assessment and may provide useful diagnostic and prognostic information, although further research is required to clarify its role in evaluating disease evolution.
KEY WORDS: SSc, Early diagnosis, Capillaroscopy, Cross-disciplinary communication
Submitted 12 February 2008;
revised version accepted 1 December 2008.
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