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ZHAO Yafang, ZHANG Chunyan, CUI Shuang. Characteristics and Associated Factors of Autoimmune Diseases-related Skin Ulcer: A Multi Center Study[J]. Medical Journal of Peking Union Medical College Hospital. DOI: 10.12290/xhyxzz.2024-0622
Citation: ZHAO Yafang, ZHANG Chunyan, CUI Shuang. Characteristics and Associated Factors of Autoimmune Diseases-related Skin Ulcer: A Multi Center Study[J]. Medical Journal of Peking Union Medical College Hospital. DOI: 10.12290/xhyxzz.2024-0622
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Characteristics and Associated Factors of Autoimmune Diseases-related Skin Ulcer: A Multi Center Study

  • 1 Department of Ophthalmology,, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China;

  • 2 Department of Rheumatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China

Funds: 

Nursing Research Fund of Peking Union Medical College Hospital 2023(XHHLKY202301)

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  • Received Date: August 09, 2024
  • Accepted Date: October 30, 2024
  • Available Online: January 20, 2025
    Graphical Abstract
    • 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.
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  • [1]
    于家傲, 赵景春. 重视自身免疫病相关性溃疡临床诊疗中的多学科协作[J]. 中华烧伤与创面修复杂志, 2022, 38(6): 501-5.
    [2]
    LI D P, HAN Y X, HE Y S, et al. A global assessment of incidence trends of autoimmune diseases from 1990 to 2019 and predicted changes to 2040[J]. Autoimmunity reviews, 2023, 22(10): 103407.
    [3]
    SHANMUGAM V K. Vasculitic Diseases and Prothrombotic States Contributing to Delayed Healing In Chronic Wounds [J]. Curr Dermatol Rep, 2016, 5(4): 270-7.
    [4]
    ANSERT E, TICKNER A, COHEN D, et al. Understanding the zebras of wound care: an overview of atypical wounds [J]. Wounds, 2022, 34(5): 124-34.
    [5]
    SHANMUGAM V K, SCHILLING A, GERMINARIO A, et al. Prevalence of immune disease in patients with wounds presenting to a tertiary wound healing centre [J]. Int Wound J, 2012, 9(4): 403-11.
    [6]
    MOORE S C, DESANTIS E R. Treatment of complications associated with systemic sclerosis [J]. American journal of health-system pharmacy: AJHP: official journal of the American Society of HealthSystem Pharmacists, 2008, 65(4): 315-21.
    [7]
    YAO Z, NIU J, CHENG B. Prevalence of Chronic Skin Wounds and Their Risk Factors in an Inpatient Hospital Setting in Northern China [J]. Adv Skin Wound Care, 2020, 33(9): 1-10.
    [8]
    陈彩虹, 姚泽欣, 陈葵, 等. 801例住院慢性创面患者的临床特点流行病学调查[J]. 中华烧伤杂志, 2020, 36(5): 388-94.
    [9]
    WANG Z, QI F, LUO H, et al. Inflammatory Microenvironment of Skin Wounds [J]. Frontiers in immunology, 2022, 13: 789274.
    [10]
    FALCONE M, DE ANGELIS B, PEA F, et al. Challenges in the management of chronic wound infections [J]. J Glob Antimicrob Resist, 2021, 26: 140-7.
    [11]
    GUEST J F, FULLER G W, VOWDEN P. Cohort study evaluating the burden of wounds to the UK's National Health Service in 2017/2018: update from 2012/2013[J]. BMJ open, 2020, 10(12): e045253.
    [12]
    WEI M, XU Y, XIA D, et al. Care and Treatment for an Antiphospholipid Syndrome-Related Lower Limb Skin Ulcer Unhealed for 7 Years: A Case Report [J]. The international journal of lower extremity wounds, 2022: 15347346221090079.
    [13]
    SHARMA AN P B. Laser Fitzpatrick Skin Type Recommendations. [Z]. Treasure Island (FL): StatPearls Publishing; StatPearls. 2023
    [14]
    HARRIS C, BATES-JENSEN B, PARSLOW N, et al. Bates-Jensen wound assessment tool: pictorial guide validation project [J]. Journal of wound, ostomy, and continence nursing: official publication of The Wound, Ostomy and Continence Nurses Society, 2010, 37(3): 253-9.
    [15]
    DELGADO D A, LAMBERT B S, BOUTRIS N, et al. Validation of Digital Visual Analog Scale Pain Scoring With a Traditional Paper-based Visual Analog Scale in Adults [J]. J Am Acad Orthop Surg Glob Res Rev, 2018, 2(3): e088.
    [16]
    VIRKKALA J, POLET S, JOKELAINEN J, et al. Clinical characteristics and comorbidities of the most common atypical wounds in Northern Finland in 1996-2019: A retrospective registry study [J]. Health Sci Rep, 2022, 5(5): e864.
    [17]
    CHENG B, JIANG Y, FU X, et al. Epidemiological characteristics and clinical analyses of chronic cutaneous wounds of inpatients in China: Prevention and control [J]. Wound Repair Regen, 2020, 28(5): 623-30.
    [18]
    LEARNED A, ROBINSON S A, NGUYEN T T. Comprehensive Care of Lower-Extremity Wounds [J]. The Surgical clinics of North America, 2023, 103(4): 745-65.
    [19]
    DINI V, SALVO P, JANOWSKA A, et al. Correlation Between Wound Temperature Obtained With an Infrared Camera and Clinical Wound Bed Score in Venous Leg Ulcers [J]. Wounds, 2015, 27(10): 274- 8.
    [20]
    SNELGROVE H, BAILEFF A. A review of interventions to reduce pain in chronic wounds [J]. British journal of community nursing, 2019, 24(Sup12): S12-S7.
    [21]
    IVORY J D, FINN D P, VELLINGA A, et al. Topical interventions for the management of pain in chronic wounds: A protocol for a systematic review [J]. HRB Open Res, 2022, 5: 58.
    [22]
    OBA Y, SAWA N, IKUMA D, et al. Successful peficitinib monotherapy for the new-onset skin manifestations of rheumatoid vasculitis after long-term treatment with tocilizumab for rheumatoid arthritis [J]. Mod Rheumatol Case Rep, 2023, 8(1): 5-10.
    [23]
    JOSE J, SONI B, JOSE S, et al. Medical Management to Treat Chronic Non-healing Ulcers: A Case Series [J]. Cureus, 2024, 16(1): e51449.
    [24]
    SIBBALD R G, COUTTS P, WOO K Y. Reduction of bacterial burden and pain in chronic wounds using a new polyhexamethylene biguanide antimicrobial foam dressing-clinical trial results [J]. Adv Skin Wound Care, 2011, 24(2): 78-84.
    [25]
    MAKOL A, MATTESON E L, WARRINGTON K J. Rheumatoid vasculitis: an update [J]. Current opinion in rheumatology, 2015, 27(1): 63-70.
    [26]
    ASHIDA A, MURATA H, MIKOSHIBA Y, et al. Successful treatment of rheumatoid vasculitisassociated skin ulcer with a TNF-alpha antagonist [J]. International journal of dermatology, 2014, 53(2): e154-6.
    [27]
    FUJIMOTO M, ASANO Y, ISHII T, et al. The wound/burn guidelines - 4: Guidelines for the management of skin ulcers associated with connective tissue disease/vasculitis [J]. The Journal of dermatology, 2016, 43(7): 729-57.
    [28]
    BOSLEY B N, WEINER D K, RUDY T E, et al. Is chronic nonmalignant pain associated with decreased appetite in older adults? Preliminary evidence [J]. Journal of the American Geriatrics Society, 2004, 52(2): 247-51.
    [29]
    MCDANIEL J C, KEMMNER K G, RUSNAK S. Nutritional profile of older adults with chronic venous leg ulcers: a pilot study [J]. Geriatric nursing (New York, NY), 2015, 36(5): 381-6.
    [30]
    GRAUE N, KORBER A, CESKO E, et al. [Malnutrition in patients with leg ulcers. Results of a clinical trial] [J]. Der Hautarzt; Zeitschrift fur Dermatologie, Venerologie, und verwandte Gebiete, 2008, 59(3): 212-9.
    [31]
    BARBER G A, WELLER C D, GIBSON S J. Effects and associations of nutrition in patients with venous leg ulcers: A systematic review [J]. Journal of advanced nursing, 2018, 74(4): 774-87.
    [32]
    HERBERGER K, MULLER K, PROTZ K, et al. Nutritional status and quality of nutrition in chronic wound patients [J]. Int Wound J, 2020, 17(5): 1246-54.
    [33]
    NICE. Nutrition Support for Adults: Oral Nutrition Support, Enteral Tube Feeding and Parenteral Nutrition [M]. Nutrition Support for Adults: Oral Nutrition Support, Enteral Tube Feeding and Parenteral Nutrition. London. 2006.
    [34]
    NOGUEIRA D A, FERREIRA L P, DE LUCIA R P A, et al. High Frequency of Non-Compliance with Quality Indicators of Enteral and Parenteral Nutritional Therapy in Hospitalized Patients [J]. Nutrients, 2020, 12(8).
    [35]
    赵令, 宿凯笙, 叶壮, 等. 自身免疫病相关性溃疡的临床特点及诊疗研究进展[J]. 中华烧伤与创面修复杂志, 2022, 38(6): 558-62.
    [36]
    赵文慧, 孟佳丹, 周芷伊, 等. “健康老龄化”背景下老年慢性病患者健康教育模式的研究进展[J]. 中国老年保健医学, 2023, 21(01): 117-21.
    [37]
    MOORE Z, DOWSETT C, SMITH G, et al. TIME CDST: an updated tool to address the current challenges in wound care [J]. J Wound Care, 2019, 28(3): 154-61.
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