Abstract:
Objective To explore the scoring level and related factors of autoimmune disease-related skin ulcers by collecting data from multiple centers, and to provide ideas and references for targeted intervention measures and management plans for clinical medical and nursing staff.
Method From December 2022 to February 2024, data related to skin ulcers in patients with autoimmune diseases from 10 hospitals in different regions of China were collected. The data includes the patient's Fitzpatrick skin type, previous sunburn history, self-care ability, time of skin ulcer occurrence, skin ulcer score, location of skin ulcer occurrence, Bates Jensen wound score (BWAT) for skin ulcer, and VAS score for skin ulcer pain. The scores of skin ulcers in patients with different characteristics were analyzed using analysis of variance or t-test, and the related factors of skin ulcer scores were analyzed using multiple linear regression.
Results Data from 304 patients were collected, with an average BWAT score of 32.0 ±8.6 for skin ulcers. The most common type of primary disease is dermatomyositis (28.9%). Skin ulcers mostly occur in the feet (22.0%), and the average VAS score for skin ulcer pain is (4.5 ±1.9) points. Multivariate linear regression analysis showed that the patient's region of origin (β=0.143), VAS score (β=0.162), wound site (β=0.168), presence of Raynaud's phenomenon (β=0.120), antibiotic use (β=1.206), and the use of glucocorticoids (β=1.189) were statistically significant factors affecting skin ulcer scores.
Conclusion The severity of skin ulcers is not related to the type of disease, and patients from economically underdeveloped and relatively cold climates have poorer skin ulcer conditions. Health education for patients should be easy to understand, emphasizing the importance of adhering to regular medication to control the progression of the primary disease, and strengthening self observation of skin changes and pain at the ulcer site. A multidisciplinary collaborative skin ulcer management plan can be constructed based on the latest TIME clinical decision support tool (TIME-CDST), as well as TIME wound management principles for managing the ulcer site.