Systemic sclerosis in an Afro-Caribbean population: a review of demographic and clinical features / Esclerosis sistémica en la población afrocaribeña: un estudio de las características demográficas y clínicas

ABSTRACT

OBJECTIVE: To assess the clinical and selected demographic features of patients with systemic sclerosis (SS) seen over a 10-year period at the Rheumatology service of the Queen Elizabeth Hospital, Barbados. To compare these data with what is known to obtain in other ethnic populations. DESIGN AND METHODS: A chart review involving all patients who were found to have SS based on the American College of Rheumatology clinical criteria was conducted between 1996 and 2006. RESULTS: Twenty-seven patients with SS were identified in this predominantly Afro-Caribbean population. The prevalent and incident cases numbered 10 and 17 respectively. Twenty-six of these patients were female and the mean age at diagnosis was 37.3 years. Diffuse cutaneous involvement was seen in 63% of cases and limited cutaneous involvement in 37%. The most common clinical features in descending order of frequency were Raynaud's phenomenon, gastroesophageal reflux, pigmentary skin changes, digital pitting/ulceration, telangiectasia and pulmonary disease. CONCLUSION: In a predominantly Afro-Caribbean population, SS was uncommonly seen, had a marked female preponderance and an earlier age of onset than that seen in Caucasian populations. As expected, diffuse disease was the more common subtype and digital pitting, pigmentary skin changes, and pulmonary disease were amongst the most frequent clinical features. Telangiectasia were found more frequently than the literature suggests is typical for patients of African descent.

RESUMEN

OBJETIVO: Evaluar los rasgos clínicos y las características demográficas seleccionadas de pacientes con esclerosis sistémica (ES) atendidos por un periodo de 10 años en el Servicio de Reumatolog?ía del Hospital Queen Elizabeth Hospital, Barbados. Comparar estos datos con lo que se conoce que existe en otras poblaciones étnicas. DISEÑO Y MÉTODOS: Entre 1996 y 2006, se llevó a cabo una revisión de historias clínicas, la cual abarcó a todos los pacientes a quienes se les diagnosticó ES, sobre la base de los criterios clínicos del Colegio Americano de Reumatología. RESULTADOS: Se identificaron veintisiete pacientes con ES en esta población predominantemente afrocaribeña. Los casos prevalentes e incidentes ascendieron a 10 y 17 respectivamente. Veintiséis de estos pacientes fueron hembras y la edad promedio en el momento del diagnóstico fue 37.3 años. En 63% de los casos se observó compromiso cutáneo difuso, en tanto que en el 37% se observó compromiso cutáneo limitado. Los rasgos clínicos más comunes en orden descendente de frecuencia fueron el fenómeno de Raynaud, el reflujo gastroesofágico, cambios de pigmentación de la piel, ulceración digital, telangiectasia y enfermedad pulmonar.