<\/span><\/strong><\/h4>\n<\/h4>\n
<\/p>\n
Prof. Dr. Ancu\u021ba Codrina<\/span><\/strong>
Universitatea de Medicin\u0103 \u0219i Farmacie \u201cGrigore T. Popa\u201d Ia\u0219i<\/span><\/strong><\/h4>\n[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=”4.16″ global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.16″ custom_padding=”|||” global_colors_info=”{}” custom_padding__hover=”|||”][et_pb_text _builder_version=”4.20.4″ hover_enabled=”0″ global_colors_info=”{}” sticky_enabled=”0″]<\/p>\n
De la sclerodermia localizat\u0103 la sclerodermia sistemic\u0103: afec\u021biuni concomitente sau spectru evolutiv<\/span><\/p>\nAutori: Codrina Ancu\u021ba1,2, Luiza Petrariu2<\/span>
1Disciplina Reumatologie, Universitatea de Medicin\u0103 \u0219i Farmacie \u201dGrigore T. Popa\u201d Ia\u0219i, Rom\u00e2nia
2Clinica Reumatologie 2, Spitalul Clinic de Recuperare Ia\u0219i, Rom\u00e2nia<\/p>\nCuvinte cheie: sclerodermie localizat\u0103, sclerodermie sistemic\u0103, spectru evolutiv, autoanticorpi, capilaroscopie<\/p>\n
Apar\u021bin\u00e2nd categoriei bolilor rare, sclerodermia sistemic\u0103 (SSc) este o afec\u021biune reumatic\u0103 autoimun\u0103 cu patobiologie multifa\u021betat\u0103, rezultat al interven\u021biei a trei evenimente patogenice cheie, vasculopatia periferic\u0103, inflama\u021bia sistemic\u0103 \u0219i fibroza (extensiv\u0103 \u0219i excesiv\u0103, deopotriv\u0103 cutanat\u0103 \u0219i visceral\u0103), interconectate pe fondul unui r\u0103spuns imun aberant. Consecin\u021b\u0103 a deterior\u0103rii \u021besutului vasculo-conjunctiv, spectrul manifest\u0103rilor clinice este extrem de heterogen, de la fenomenul Raynaud cu pattern capilaroscopic specific la afectarea visceral\u0103 polimorf\u0103 (pulmonar\u0103, cardiac\u0103, digestiv\u0103, renal\u0103), ce permite stratificarea pe subtipuri de boal\u0103, cu implica\u021bii prognostice \u0219i terapeutice.
Sclerodermia localizat\u0103 (LoS) r\u0103m\u00e2ne prin excelen\u021b\u0103 o boal\u0103 dermatologic\u0103 de etiologie autoimun\u0103, caracterizat\u0103 prin leziuni cutanate specifice, absen\u021ba fenomenului Raynaud, a sclerodactiliei \u0219i leziunilor capilaroscopice. De\u0219i nu exist\u0103 diferen\u021be histopatologice \u00eentre LoS \u0219i SSc, LoS este o entitate paucisimptomatic\u0103 \u00een care componenta cutanat\u0103 este esen\u021bial\u0103, dar care se poate acompania de simptomatologie sistemic\u0103 nespecific\u0103, eventual prezen\u021ba autoanticorpilor serici, f\u0103r\u0103 a dezvolta visceraliz\u0103rile tipice SSc.
De cele mai multe ori, evolu\u021bia LoS este benign\u0103, eventual cu rezolu\u021bia leziunilor cutanate; exist\u0103 \u00eens\u0103 situa\u021bii \u00een care LoS dep\u0103\u0219e\u0219te grani\u021bele unei patologii strict cutanate decel\u00e2ndu-se visceraliz\u0103ri \u0219i evolu\u021bia c\u0103tre forma sistemic\u0103, mai ales c\u00e2nd ne raport\u0103m la LoS cu debut juvenil.
Ne propunem, astfel, o dezbatere pe tema \u201dSunt \u00eentr-adev\u0103r SSc \u0219i LoC dou\u0103 entit\u0103\u021bi clinice distincte cu background autoimun, apar\u021bin\u00e2nd unor domenii diferite (reumatologie respectiv dermatologie), f\u0103r\u0103 nici o alt\u0103 legatur\u0103 dec\u00e2t cea histopatologic\u0103, dar care pot coexista?\u201d, sau, de fapt, \u201dCele dou\u0103 entit\u0103\u021bi apar\u021bin unui spectru unic de boal\u0103?\u201d.<\/p>\n
From localized scleroderma to systemic sclerosis: co-occurrence or predictable evolution<\/span><\/p>\nAuthors: Codrina Ancu\u021ba1,2, Luiza Petrariu2<\/span>
1Rheumatology Dept., University of Medicine and Pharmacy \u201dGrigore T. Popa\u201d Iasi, Romania
2Rheumatology 2, Clinical Rehabilitation Hospital, Iasi, Romania<\/p>\nKewwords: localized scleroderma; systemic scleroderma; disease spectrum; autoantibodies; capillaroscopy<\/p>\n
Classified as an orphan disease, systemic scleroderma (SSc) is an autoimmune rheumatic condition with a complex multifaceted pathobiology, resulting from the intervention of three key pathogenic events – peripheral vasculopathy, systemic inflammation and fibrosis (extensive and excessive, both cutaneous and visceral) with a background of an aberrant immune response. As a consequence of connective tissue damage, the spectrum of clinical manifestations is challenging, ranging from Raynaud’s phenomenon with a specific capillaroscopic pattern to visceral damage (pulmonary, cardiac, digestive, renal), which allows stratification by disease subtypes, with prognostic implications and therapeutic.
Localized scleroderma (LoS) remains an autoimmune dermatological condition, characterized by specific skin lesions, the absence of Raynaud’s phenomenon, sclerodactyly and capillaroscopic lesions. Although there are no histopathological differences between LoS and SSc, LoS is a pauci-symptomatic entity in which the skin involvement is essential, but which may be accompanied by nonspecific systemic manifestations, serum autoantibodies, but without any typical visceral involvement of SSc.
Most of the time, the evolution of LoS is benign, with potential resolution of the skin lesions; however, there are situations in which LoS exceeds the boundaries of a strictly cutaneous pathology, disclosing visceral involvement as well as the evolution towards the systemic form, especially when we refer to juvenile onset LoS.
We intend to debate on the topic “Are SSc and LoC two distinct clinical entities with an autoimmune background, belonging to different fields (rheumatology and dermatology respectively), with no connection other than the histopathological one, but which can coexist?”, or, in fact, “Do the two entities belong to a disease spectrum?”.<\/p>\n
Scurt CV<\/span><\/p>\nProfesor universitar, Disciplina Reumatologie, Recuperare, Medicin\u0103 Fizic\u0103 \u0219i Balneologie, Universitatea de Medicin\u0103 \u0219i Farmacie \u201cGrigore T. Popa\u201d Ia\u0219i.
Medic primar reumatologie \u0219i reabilitare, \u0219ef clinica Reumatologie 2, Spitalul Clinic Recuperare Ia\u0219i
Coordonator Centru EUSTAR 162, afiliat re\u021belei EUSTAR (European Scleroderma Trials and Research Group),
Coordonator Centru Capilaroscopie \u2013 Network of imaging training center 2016-2021 (EULAR)
Training in capilaroscopie (Paris, Fran\u021ba 2004), ecografie musculoscheletala (Paris, Fran\u021ba, 2004; Barcelona, Spania, 2008); osteodensitometrie DXA (Bucure\u0219ti, Rom\u00e2nia, 2006).
Membru \u00een societ\u0103\u021bi stiin\u021bifice interna\u021bionale:<\/strong> EUSTAR, IASP (Interna\u021bional Associa\u021bion for the Study of Pain) \u0219i Special Interest Group Musculoskeletal Pain, SLEuro (European Lupus Society)
Domenii de interes:<\/strong> terapia biologica \u00een patologia reumatismala imun mediat\u0103, orphan disease (Sclerodermia sistemic\u0103, miopatii inflamatorii idiopatice), sarcina \u0219i patologia reumatismala imun mediat\u0103<\/p>\n[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=”1″ _builder_version=”4.19.4″ background_color=”rgba(240,98,42,0.19)” background_image=”https:\/\/pdi.ro\/2023\/wp-content\/uploads\/2022\/12\/PDI2023_header__-scaled.jpg” background_blend=”multiply” custom_padding=”54px|0px|0|0px|false|false” top_divider_style=”waves2″ top_divider_color=”#ffffff” top_divider_height=”155px” top_divider_height_tablet=”” top_divider_height_phone=”97px” top_divider_height_last_edited=”on|desktop” bottom_divider_style=”waves2″ bottom_divider_color=”#F0622A” bottom_divider_flip=”vertical” bottom_divider_height_tablet=”” bottom_divider_height_phone=”59px” bottom_divider_height_last_edited=”on|desktop” global_module=”9177″ saved_tabs=”all” global_colors_info=”{}”][et_pb_row column_structure=”3_5,2_5″ _builder_version=”4.19.4″ custom_padding=”100px|0px|69px|0px|false|false” global_colors_info=”{}”][et_pb_column type=”3_5″ _builder_version=”4.16″ custom_padding=”|||” global_colors_info=”{}” custom_padding__hover=”|||”][et_pb_text disabled_on=”off|off|off” _builder_version=”4.20.2″ text_font=”Kaushan Script||||||||” text_text_color=”#f0622a” text_font_size=”30px” text_line_height=”1.2em” header_font=”||||||||” background_layout=”dark” text_font_size_tablet=”” text_font_size_phone=”” text_font_size_last_edited=”on|desktop” global_colors_info=”{}”]<\/p>\n
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Prof. Dr. Ancu\u021ba CodrinaUniversitatea de Medicin\u0103 \u0219i Farmacie \u201cGrigore T. Popa\u201d Ia\u0219iDe la sclerodermia localizat\u0103 la sclerodermia sistemic\u0103: afec\u021biuni concomitente sau spectru evolutiv Autori: Codrina Ancu\u021ba1,2, Luiza Petrariu21Disciplina Reumatologie, Universitatea de Medicin\u0103 \u0219i Farmacie \u201dGrigore T. Popa\u201d Ia\u0219i, Rom\u00e2nia2Clinica Reumatologie 2, Spitalul Clinic de Recuperare Ia\u0219i, Rom\u00e2nia Cuvinte cheie: sclerodermie localizat\u0103, sclerodermie sistemic\u0103, spectru […]<\/p>\n","protected":false},"author":2,"featured_media":11626,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"categories":[12],"tags":[],"class_list":["post-8407","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-lectori"],"_links":{"self":[{"href":"https:\/\/pdi.ro\/2023\/wp-json\/wp\/v2\/posts\/8407","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pdi.ro\/2023\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/pdi.ro\/2023\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/pdi.ro\/2023\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/pdi.ro\/2023\/wp-json\/wp\/v2\/comments?post=8407"}],"version-history":[{"count":18,"href":"https:\/\/pdi.ro\/2023\/wp-json\/wp\/v2\/posts\/8407\/revisions"}],"predecessor-version":[{"id":13140,"href":"https:\/\/pdi.ro\/2023\/wp-json\/wp\/v2\/posts\/8407\/revisions\/13140"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/pdi.ro\/2023\/wp-json\/wp\/v2\/media\/11626"}],"wp:attachment":[{"href":"https:\/\/pdi.ro\/2023\/wp-json\/wp\/v2\/media?parent=8407"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/pdi.ro\/2023\/wp-json\/wp\/v2\/categories?post=8407"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/pdi.ro\/2023\/wp-json\/wp\/v2\/tags?post=8407"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
Universitatea de Medicin\u0103 \u0219i Farmacie \u201cGrigore T. Popa\u201d Ia\u0219i<\/span><\/strong><\/h4>\n
[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=”4.16″ global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.16″ custom_padding=”|||” global_colors_info=”{}” custom_padding__hover=”|||”][et_pb_text _builder_version=”4.20.4″ hover_enabled=”0″ global_colors_info=”{}” sticky_enabled=”0″]<\/p>\n
De la sclerodermia localizat\u0103 la sclerodermia sistemic\u0103: afec\u021biuni concomitente sau spectru evolutiv<\/span><\/p>\n Autori: Codrina Ancu\u021ba1,2, Luiza Petrariu2<\/span> Cuvinte cheie: sclerodermie localizat\u0103, sclerodermie sistemic\u0103, spectru evolutiv, autoanticorpi, capilaroscopie<\/p>\n Apar\u021bin\u00e2nd categoriei bolilor rare, sclerodermia sistemic\u0103 (SSc) este o afec\u021biune reumatic\u0103 autoimun\u0103 cu patobiologie multifa\u021betat\u0103, rezultat al interven\u021biei a trei evenimente patogenice cheie, vasculopatia periferic\u0103, inflama\u021bia sistemic\u0103 \u0219i fibroza (extensiv\u0103 \u0219i excesiv\u0103, deopotriv\u0103 cutanat\u0103 \u0219i visceral\u0103), interconectate pe fondul unui r\u0103spuns imun aberant. Consecin\u021b\u0103 a deterior\u0103rii \u021besutului vasculo-conjunctiv, spectrul manifest\u0103rilor clinice este extrem de heterogen, de la fenomenul Raynaud cu pattern capilaroscopic specific la afectarea visceral\u0103 polimorf\u0103 (pulmonar\u0103, cardiac\u0103, digestiv\u0103, renal\u0103), ce permite stratificarea pe subtipuri de boal\u0103, cu implica\u021bii prognostice \u0219i terapeutice. From localized scleroderma to systemic sclerosis: co-occurrence or predictable evolution<\/span><\/p>\n Authors: Codrina Ancu\u021ba1,2, Luiza Petrariu2<\/span> Kewwords: localized scleroderma; systemic scleroderma; disease spectrum; autoantibodies; capillaroscopy<\/p>\n Classified as an orphan disease, systemic scleroderma (SSc) is an autoimmune rheumatic condition with a complex multifaceted pathobiology, resulting from the intervention of three key pathogenic events – peripheral vasculopathy, systemic inflammation and fibrosis (extensive and excessive, both cutaneous and visceral) with a background of an aberrant immune response. As a consequence of connective tissue damage, the spectrum of clinical manifestations is challenging, ranging from Raynaud’s phenomenon with a specific capillaroscopic pattern to visceral damage (pulmonary, cardiac, digestive, renal), which allows stratification by disease subtypes, with prognostic implications and therapeutic. Scurt CV<\/span><\/p>\n Profesor universitar, Disciplina Reumatologie, Recuperare, Medicin\u0103 Fizic\u0103 \u0219i Balneologie, Universitatea de Medicin\u0103 \u0219i Farmacie \u201cGrigore T. Popa\u201d Ia\u0219i. 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Popa\u201d Ia\u0219iDe la sclerodermia localizat\u0103 la sclerodermia sistemic\u0103: afec\u021biuni concomitente sau spectru evolutiv Autori: Codrina Ancu\u021ba1,2, Luiza Petrariu21Disciplina Reumatologie, Universitatea de Medicin\u0103 \u0219i Farmacie \u201dGrigore T. Popa\u201d Ia\u0219i, Rom\u00e2nia2Clinica Reumatologie 2, Spitalul Clinic de Recuperare Ia\u0219i, Rom\u00e2nia Cuvinte cheie: sclerodermie localizat\u0103, sclerodermie sistemic\u0103, spectru […]<\/p>\n","protected":false},"author":2,"featured_media":11626,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"categories":[12],"tags":[],"class_list":["post-8407","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-lectori"],"_links":{"self":[{"href":"https:\/\/pdi.ro\/2023\/wp-json\/wp\/v2\/posts\/8407","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pdi.ro\/2023\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/pdi.ro\/2023\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/pdi.ro\/2023\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/pdi.ro\/2023\/wp-json\/wp\/v2\/comments?post=8407"}],"version-history":[{"count":18,"href":"https:\/\/pdi.ro\/2023\/wp-json\/wp\/v2\/posts\/8407\/revisions"}],"predecessor-version":[{"id":13140,"href":"https:\/\/pdi.ro\/2023\/wp-json\/wp\/v2\/posts\/8407\/revisions\/13140"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/pdi.ro\/2023\/wp-json\/wp\/v2\/media\/11626"}],"wp:attachment":[{"href":"https:\/\/pdi.ro\/2023\/wp-json\/wp\/v2\/media?parent=8407"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/pdi.ro\/2023\/wp-json\/wp\/v2\/categories?post=8407"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/pdi.ro\/2023\/wp-json\/wp\/v2\/tags?post=8407"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
1Disciplina Reumatologie, Universitatea de Medicin\u0103 \u0219i Farmacie \u201dGrigore T. Popa\u201d Ia\u0219i, Rom\u00e2nia
2Clinica Reumatologie 2, Spitalul Clinic de Recuperare Ia\u0219i, Rom\u00e2nia<\/p>\n
Sclerodermia localizat\u0103 (LoS) r\u0103m\u00e2ne prin excelen\u021b\u0103 o boal\u0103 dermatologic\u0103 de etiologie autoimun\u0103, caracterizat\u0103 prin leziuni cutanate specifice, absen\u021ba fenomenului Raynaud, a sclerodactiliei \u0219i leziunilor capilaroscopice. De\u0219i nu exist\u0103 diferen\u021be histopatologice \u00eentre LoS \u0219i SSc, LoS este o entitate paucisimptomatic\u0103 \u00een care componenta cutanat\u0103 este esen\u021bial\u0103, dar care se poate acompania de simptomatologie sistemic\u0103 nespecific\u0103, eventual prezen\u021ba autoanticorpilor serici, f\u0103r\u0103 a dezvolta visceraliz\u0103rile tipice SSc.
De cele mai multe ori, evolu\u021bia LoS este benign\u0103, eventual cu rezolu\u021bia leziunilor cutanate; exist\u0103 \u00eens\u0103 situa\u021bii \u00een care LoS dep\u0103\u0219e\u0219te grani\u021bele unei patologii strict cutanate decel\u00e2ndu-se visceraliz\u0103ri \u0219i evolu\u021bia c\u0103tre forma sistemic\u0103, mai ales c\u00e2nd ne raport\u0103m la LoS cu debut juvenil.
Ne propunem, astfel, o dezbatere pe tema \u201dSunt \u00eentr-adev\u0103r SSc \u0219i LoC dou\u0103 entit\u0103\u021bi clinice distincte cu background autoimun, apar\u021bin\u00e2nd unor domenii diferite (reumatologie respectiv dermatologie), f\u0103r\u0103 nici o alt\u0103 legatur\u0103 dec\u00e2t cea histopatologic\u0103, dar care pot coexista?\u201d, sau, de fapt, \u201dCele dou\u0103 entit\u0103\u021bi apar\u021bin unui spectru unic de boal\u0103?\u201d.<\/p>\n
1Rheumatology Dept., University of Medicine and Pharmacy \u201dGrigore T. Popa\u201d Iasi, Romania
2Rheumatology 2, Clinical Rehabilitation Hospital, Iasi, Romania<\/p>\n
Localized scleroderma (LoS) remains an autoimmune dermatological condition, characterized by specific skin lesions, the absence of Raynaud’s phenomenon, sclerodactyly and capillaroscopic lesions. Although there are no histopathological differences between LoS and SSc, LoS is a pauci-symptomatic entity in which the skin involvement is essential, but which may be accompanied by nonspecific systemic manifestations, serum autoantibodies, but without any typical visceral involvement of SSc.
Most of the time, the evolution of LoS is benign, with potential resolution of the skin lesions; however, there are situations in which LoS exceeds the boundaries of a strictly cutaneous pathology, disclosing visceral involvement as well as the evolution towards the systemic form, especially when we refer to juvenile onset LoS.
We intend to debate on the topic “Are SSc and LoC two distinct clinical entities with an autoimmune background, belonging to different fields (rheumatology and dermatology respectively), with no connection other than the histopathological one, but which can coexist?”, or, in fact, “Do the two entities belong to a disease spectrum?”.<\/p>\n
Medic primar reumatologie \u0219i reabilitare, \u0219ef clinica Reumatologie 2, Spitalul Clinic Recuperare Ia\u0219i
Coordonator Centru EUSTAR 162, afiliat re\u021belei EUSTAR (European Scleroderma Trials and Research Group),
Coordonator Centru Capilaroscopie \u2013 Network of imaging training center 2016-2021 (EULAR)
Training in capilaroscopie (Paris, Fran\u021ba 2004), ecografie musculoscheletala (Paris, Fran\u021ba, 2004; Barcelona, Spania, 2008); osteodensitometrie DXA (Bucure\u0219ti, Rom\u00e2nia, 2006).
Membru \u00een societ\u0103\u021bi stiin\u021bifice interna\u021bionale:<\/strong> EUSTAR, IASP (Interna\u021bional Associa\u021bion for the Study of Pain) \u0219i Special Interest Group Musculoskeletal Pain, SLEuro (European Lupus Society)
Domenii de interes:<\/strong> terapia biologica \u00een patologia reumatismala imun mediat\u0103, orphan disease (Sclerodermia sistemic\u0103, miopatii inflamatorii idiopatice), sarcina \u0219i patologia reumatismala imun mediat\u0103<\/p>\n<\/span><\/p>\n
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