{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T21:26:19Z","timestamp":1792531579272,"version":"4.5.0"},"reference-count":20,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2019,7,3]],"date-time":"2019-07-03T00:00:00Z","timestamp":1562112000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp; Research"],"published-print":{"date-parts":[[2019,8]]},"abstract":"Objective<\/jats:title>Assessment of Raynaud's phenomenon (RP<\/jats:styled-content>) in systemic sclerosis (SS<\/jats:styled-content>c) is reliant on self\u2010report. The Raynaud's Condition Score (RCS<\/jats:styled-content>) diary assumes discrete episodic RP<\/jats:styled-content> attacks, although not all SS<\/jats:styled-content>c patients identify with this paradigm. We investigated the clinical associations of SS<\/jats:styled-content>c\u2010RP<\/jats:styled-content> symptom characteristics and the evolution of SS<\/jats:styled-content>c\u2010RP<\/jats:styled-content> symptoms with disease progression.<\/jats:p><\/jats:sec>Methods<\/jats:title>A cross\u2010sectional study at UK<\/jats:styled-content> and US<\/jats:styled-content> sites captured digital color changes of SS<\/jats:styled-content>c\u2010RP<\/jats:styled-content> and patients\u2019 ability to identify with diagrammatic representations (and descriptive stems) of 4 distinct theoretical SS<\/jats:styled-content>c\u2010RP<\/jats:styled-content> patterns (progressing severity A through D) reflecting progressively severe SS<\/jats:styled-content>c\u2010RP<\/jats:styled-content> experiences. SS<\/jats:styled-content>c\u2010RP<\/jats:styled-content> self\u2010management and symptom evolution were explored. Patient demographics, the clinical phenotype, the Scleroderma Health Assessment Questionnaire (SHAQ<\/jats:styled-content>), the 2\u2010week RCS<\/jats:styled-content> diary, and patient and physician global assessments were collected.<\/jats:p><\/jats:sec>Results<\/jats:title>We enrolled 107 patients with SS<\/jats:styled-content>c (with questionnaires returned by 94). A higher number of self\u2010reported digital color changes of SS<\/jats:styled-content>c\u2010RP<\/jats:styled-content> were associated with increased SS<\/jats:styled-content>c\u2010RP<\/jats:styled-content> symptom severity but not with the SS<\/jats:styled-content>c clinical phenotype. Patients could identify with distinct patterns of SS<\/jats:styled-content>c\u2010RP<\/jats:styled-content>. These patterns were associated with disease duration, global disease severity, and conceptually linked physician and patient assessments of peripheral vascular severity (e.g., SHAQ RP<\/jats:styled-content> subscale and RCS<\/jats:styled-content> diary parameters), but not with conceptually unrelated outcomes (e.g., SHAQ<\/jats:styled-content> breathing subscale). SS<\/jats:styled-content>c\u2010RP<\/jats:styled-content> characteristics and symptom severity evolve during the disease course.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>Patients identify with distinct patterns of SS<\/jats:styled-content>c\u2010RP<\/jats:styled-content> that may relate to progression of the obliterative microangiopathy of SS<\/jats:styled-content>c. Difficulty distinguishing discrete SS<\/jats:styled-content>c\u2010RP<\/jats:styled-content> attacks from persistent digital ischemia in patients with advanced SS<\/jats:styled-content>c could influence diary\u2010based approaches to assessing SS<\/jats:styled-content>c\u2010RP<\/jats:styled-content>, with implications for future clinical trials.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.23729","type":"journal-article","created":{"date-parts":[[2018,8,22]],"date-time":"2018-08-22T11:57:04Z","timestamp":1534939024000},"page":"1119-1126","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Evolving Symptom Characteristics of Raynaud's Phenomenon in Systemic Sclerosis and Their Association With Physician and Patient\u2010Reported Assessments of Disease Severity"],"prefix":"10.1002","volume":"71","author":[{"given":"John D.","family":"Pauling","sequence":"first","affiliation":[{"name":"Royal National Hospital for 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City"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,7,3]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1507638"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keq310"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/key026"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.23475"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2014.01.020"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.38098"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/32.5.357"},{"key":"e_1_2_6_9_1","first-page":"454","article-title":"Diagnosis of Raynaud's phenomenon assisted by color charts","volume":"15","author":"Maricq HR","year":"1988","journal-title":"J 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