Miziołek Bartosz, Lis-Święty Anna, Kucharz Eugeniusz, Pieczyrak Robert, Polak Karina, Szczepanek Michał, Bergler-Czop Beata
Department of Dermatology, School of Medicine in Katowice, Medical University of Silesia, 20/24 Francuska St., 40-027, Katowice, Poland.
Department of Internal Medicine Rheumatology and Clinical Immunology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland.
Arch Dermatol Res. 2023 Apr;315(3):387-393. doi: 10.1007/s00403-022-02356-w. Epub 2022 May 9.
Recurrent changes of temperature and persistence of cooling along fingers at the room temperature make hands the most frequent region of interest for thermography in systemic sclerosis (SSc). The aim of this study was to evaluate dependance of temperature in hands on a subtype of the disease, immune profile of antinuclear antibodies (ANA), and lung involvement. There were 29 patients with limited cutaneous involvement (lcSSc) and 10 patients with diffuse cutaneous disease (dcSSc) enrolled for the study. To compare measurements to normal values, there were enrolled 29 healthy volunteers (control group). All participants were submitted to thermography with handheld camera FLIR One Pro for iOS, attached to mobile phone iPhone 11, at the fixed temperature of 21 °C. Measurements included average temperature (T) over nailfolds in thumbs and fingers II-V, as well as the difference in average temperatures (TΔ) between metacarpus of the hand and its thumb and fingers II-V. Both thumbs and fingers II-V remained cooler in subjects with dcSSc compared to those with lcSSc. This implicated a significantly greater TΔ along thumbs and fingers II-V in dcSSc group. Although T at nailfolds in SSc patients was not lower than in healthy controls, TΔ remained significantly more pronounced in both lcSSc and dcSSc subjects. A positivity to ACA in lcSSc group was found to be associated with significantly lower T and more pronounced TΔ in fingers II-V than the presence of anti-Scl70 antibodies. Temperature measurements remained statistically independent on a presence of ILD in lcSSc group, but both thumbs and fingers II-V in dcSSc group were warmer in case of lung involvement. The study showed the dcSSc subtype, the positivity of ACA in lcSSc, but not lung involvement were associated with poorer thermal control in the hands of SSc patients. A comparison to healthy controls highlighted the weakness of temperature measurements at nailfolds (T) but increased the value of TΔ in thermography of hands.
在室温下，手指反复出现的温度变化以及持续的冷却现象，使得手部成为系统性硬化症（SSc）热成像检查中最常关注的部位。本研究的目的是评估手部温度与疾病亚型、抗核抗体（ANA）免疫谱以及肺部受累情况之间的相关性。本研究纳入了29例局限性皮肤受累（lcSSc）患者和10例弥漫性皮肤疾病（dcSSc）患者。为了将测量结果与正常值进行比较，招募了29名健康志愿者作为对照组。所有参与者均在21°C的固定温度下，使用连接到苹果iPhone 11手机的iOS版手持FLIR One Pro相机进行热成像检查。测量内容包括拇指以及示指至小指指甲襞的平均温度（T），以及手部掌骨与其拇指和示指至小指之间的平均温度差（TΔ）。与lcSSc患者相比，dcSSc患者的拇指和示指至小指温度更低。这意味着dcSSc组拇指和示指至小指的TΔ明显更大。尽管SSc患者指甲襞处的T不低于健康对照组，但lcSSc和dcSSc患者的TΔ仍明显更显著。发现lcSSc组中抗着丝点抗体（ACA）阳性与示指至小指的T显著降低以及TΔ更明显有关，这一情况比抗Scl70抗体阳性时更为明显。lcSSc组中，温度测量结果在统计学上与间质性肺病（ILD）的存在无关，但dcSSc组中，肺部受累时拇指和示指至小指的温度更高。该研究表明，dcSSc亚型、lcSSc中ACA阳性，但不包括肺部受累情况，与SSc患者手部较差的温度调节有关。与健康对照组的比较突出了指甲襞处温度测量值（T）的不足，但增加了手部热成像中TΔ的价值。
