{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T23:16:22Z","timestamp":1767136582483,"version":"build-2238731810"},"reference-count":5,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,12,31]],"date-time":"2024-12-31T00:00:00Z","timestamp":1735603200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ACR Open Rheumatology"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:p>A 60\u2010year\u2010old man with a significant 20\u2010year history of smoking, averaging approximately 20 cigarettes per day, presented with type 2 diabetes mellitus, hypercholesterolemia, and hypertension. Over the preceding three months, the patient reported recurrent episodes of acrocyanosis and erythema of the hands that were primarily induced by cold exposure. A capillaroscopy conducted in November 2024 revealed a \u201cscleroderma\u2010like pattern\u201d that was characterized by enlarged capillaries, megacapillaries, and a capillary density of fewer than eight capillaries per millimeter. Comprehensive immunologic and instrumental assessments demonstrated no evidence of systemic involvement or autoimmune disease. This case emphasizes the need to recognize the substantial role of cardiometabolic risk factors, including smoking, diabetes, hypertension, and hypercholesterolemia, in contributing to capillaroscopic abnormalities that may mimic systemic sclerosis. In this patient, the cumulative impact of these cardiometabolic factors culminated in the establishment of an \u201cscleroderma\u2010like pattern\u201d observed on nailfold capillaroscopy.<\/jats:p>","DOI":"10.1002\/acr2.11784","type":"journal-article","created":{"date-parts":[[2024,12,31]],"date-time":"2024-12-31T03:39:17Z","timestamp":1735616357000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Multifactorial Induction of a \u201cScleroderma\u2010Like Pattern\u201d Without Underlying Connective Tissue Disease: Diagnostic and Therapeutic Implications"],"prefix":"10.1002","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-0802-6825","authenticated-orcid":false,"given":"Angelo","family":"Nigro","sequence":"first","affiliation":[{"name":"Madonna delle Grazie Hospital  Matera Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,12,31]]},"reference":[{"key":"e_1_2_3_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41584-021-00685-0"},{"key":"e_1_2_3_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mvr.2019.03.004"},{"key":"e_1_2_3_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keae197"},{"issue":"3","key":"e_1_2_3_5_1","first-page":"25","article-title":"Smoking and systemic sclerosis: influence on microangiopathy and expression of anti\u2010topoisomerase I antibodies in a monocentric cohort","volume":"38","author":"Ciaffi J","year":"2020","journal-title":"Clin Exp Rheumatol."},{"key":"e_1_2_3_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mvr.2024.104693"}],"updated-by":[{"DOI":"10.1002\/acr2.70028","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T00:00:00Z","timestamp":1744243200000}}],"container-title":["ACR Open Rheumatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acr2.11784","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T15:25:30Z","timestamp":1759418730000},"score":1,"resource":{"primary":{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/10.1002\/acr2.11784"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,31]]},"references-count":5,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1002\/acr2.11784"],"URL":"https:\/\/doi.org\/10.1002\/acr2.11784","archive":["Portico"],"relation":{},"ISSN":["2578-5745","2578-5745"],"issn-type":[{"value":"2578-5745","type":"print"},{"value":"2578-5745","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,31]]},"assertion":[{"value":"2024-11-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-11-22","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-31","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e11784"}}