{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T12:34:23Z","timestamp":1780403663965,"version":"3.54.1"},"reference-count":15,"publisher":"American Medical Association (AMA)","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Dermatol"],"published-print":{"date-parts":[[2024,12,1]]},"abstract":"<jats:sec id=\"ab-dbr240017-4\"><jats:title>Importance<\/jats:title><jats:p>Lipodermatosclerosis (LDS) stems from vascular dysfunction and dermal inflammation and thereby is mechanistically similar to systemic sclerosis (SSc). The association of LDS with SSc in the clinical setting has not been well characterized in the literature.<\/jats:p><\/jats:sec><jats:sec id=\"ab-dbr240017-5\"><jats:title>Objective<\/jats:title><jats:p>To evaluate the prevalence of LDS in SSc and the association of LDS with vascular complications, particularly pulmonary hypertension, in patients with SSc.<\/jats:p><\/jats:sec><jats:sec id=\"ab-dbr240017-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>This retrospective cohort study used prospectively collected longitudinal data from a cohort of patients from the multidisciplinary rheumatology and dermatology clinic at a single tertiary care center from November 2004 to November 2022. Adult patients (aged \u226518 years at the time of cohort entry) with SSc were included.<\/jats:p><\/jats:sec><jats:sec id=\"ab-dbr240017-7\"><jats:title>Exposure<\/jats:title><jats:p>Clinical diagnosis of LDS based on expert opinion or histopathologic findings.<\/jats:p><\/jats:sec><jats:sec id=\"ab-dbr240017-8\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>The main outcomes included prevalence of LDS, the association of LDS with the macrovascular complications, including pulmonary hypertension, digital gangrene and\/or scleroderma renal crisis. Disease complications, including cardiac arrhythmias and heart failure, were compared among patients with and without LDS.<\/jats:p><\/jats:sec><jats:sec id=\"ab-dbr240017-9\"><jats:title>Results<\/jats:title><jats:p>Among 567 patients with SSc (494 [87.1%] female; mean [SD] age, 53.4 [14.4] years), 25 (4.4%) had LDS and 542 (95.6%) did not have LDS. Skin ulceration occurred in 8 patients with LDS (32.0%). Patients with LDS had higher frequencies of cardiac arrhythmia (11 of 24 [45.8%] vs 145 of 539 [26.9%]), heart failure (7 [28.0%] vs 55 [10.1%]), and pulmonary hypertension (12 [48.0%] vs 137 of 541 [25.3%]) compared with patients without LDS. Frequency of scleroderma renal crisis and digital gangrene did not differ significantly between patients with and without LDS (0 vs 37 [6.8%] and 4 [16.0%] vs 69 of 538 [12.8%], respectively). Among patients with LDS, 9 (36.0%) were either discharged to hospice or died during follow-up compared with 115 patients without LDS (21.2%). Lipodermatosclerosis was associated with pulmonary hypertension (adjusted prevalence odds ratio, 3.10; 95% CI, 1.33-7.25).<\/jats:p><\/jats:sec><jats:sec id=\"ab-dbr240017-10\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>In this cohort study, LDS was a rare clinical manifestation in patients with SSc but was associated with pulmonary hypertension. Therefore, patients with LDS should be closely monitored and screened for pulmonary hypertension.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamadermatol.2024.3929","type":"journal-article","created":{"date-parts":[[2024,10,16]],"date-time":"2024-10-16T15:01:37Z","timestamp":1729090897000},"page":"1329","source":"Crossref","is-referenced-by-count":1,"title":["Lipodermatosclerosis and Pulmonary Hypertension in Systemic Sclerosis"],"prefix":"10.1001","volume":"160","author":[{"given":"Srijana","family":"Davuluri","sequence":"first","affiliation":[{"name":"Division of Immunology and Rheumatology, Stanford School of Medicine, Palo Alto, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Puneet","family":"Kapoor","sequence":"additional","affiliation":[{"name":"Division of Immunology and Rheumatology, Stanford School of Medicine, Palo Alto, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Swarna","family":"Nandyala","sequence":"additional","affiliation":[{"name":"Division of Immunology and Rheumatology, Stanford School of Medicine, Palo Alto, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shufeng","family":"Li","sequence":"additional","affiliation":[{"name":"Division of Immunology and Rheumatology, Stanford School of Medicine, Palo Alto, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Simard","sequence":"additional","affiliation":[{"name":"Division of Immunology and Rheumatology, Stanford School of Medicine, Palo Alto, California"},{"name":"Division of Epidemiology and Population Health, Stanford University, Stanford, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Lewis","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Stanford School of Medicine, Stanford, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Fiorentino","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Stanford School of Medicine, Stanford, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorinda","family":"Chung","sequence":"additional","affiliation":[{"name":"Division of Immunology and Rheumatology, Stanford School of Medicine, Palo Alto, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"4","key":"dbr240017r1","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1111\/j.1529-8019.2010.01338.x","article-title":"Lipodermatosclerosis.","volume":"23","author":"Miteva","year":"2010","journal-title":"Dermatol Ther"},{"issue":"4","key":"dbr240017r2","doi-asserted-by":"publisher","first-page":"554","DOI":"10.1001\/archderm.1991.04510010122016","article-title":"Sclerosing panniculitis: a clinicopathologic assessment.","volume":"127","author":"Jorizzo","year":"1991","journal-title":"Arch Dermatol"},{"issue":"10","key":"dbr240017r3","doi-asserted-by":"publisher","first-page":"1847","DOI":"10.1007\/s00296-017-3826-y","article-title":"Determinants of mortality in systemic sclerosis: a focused review.","volume":"38","author":"Poudel","year":"2018","journal-title":"Rheumatol Int"},{"issue":"2","key":"dbr240017r4","doi-asserted-by":"publisher","first-page":"208","DOI":"10.1016\/j.semarthrit.2014.05.010","article-title":"Mortality and survival in systemic sclerosis: systematic review and meta-analysis.","volume":"44","author":"Rubio-Rivas","year":"2014","journal-title":"Semin Arthritis Rheum"},{"issue":"4","key":"dbr240017r5","doi-asserted-by":"publisher","first-page":"445","DOI":"10.1111\/imj.14376","article-title":"Scleroderma in Cairns: an epidemiological study.","volume":"50","author":"Abbot","year":"2020","journal-title":"Intern Med 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Med"},{"issue":"7","key":"dbr240017r12","doi-asserted-by":"publisher","first-page":"513","DOI":"10.1177\/0268355520901903","article-title":"Association between right heart diastolic function and clinical presentation of chronic venous disease and primary varicose veins of lower extremities.","volume":"35","author":"Rusinovich","year":"2020","journal-title":"Phlebology"},{"issue":"4","key":"dbr240017r13","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1177\/02683555231162294","article-title":"Association between cardiac conditions with venous leg ulcers in patients with chronic venous insufficiency.","volume":"38","author":"Pizano","year":"2023","journal-title":"Phlebology"},{"issue":"1","key":"dbr240017r14","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1007\/s10067-019-04810-z","article-title":"Prevalence of malnutrition in systemic sclerosis patients assessed by different diagnostic tools.","volume":"39","author":"Wojteczek","year":"2020","journal-title":"Clin 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