Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.


The Psychological Impact of Systemic Sclerosis-Related Telangiectases.

Ennis3,  Holly, Richards1,  Helen L., Cassidy3,  Claire, Herrick2,  Ariane L.

Mercy University Hospital, Cork, Co. Cork, Ireland
Rheumatic Diseases Centre, Trust Salford, United Kingdom
University of Manchester, Manchester, United Kingdom

Background:

Systemic sclerosis (SSc)-related telangiectases commonly occur on the face and hands and, although often disfiguring, little is known about their psychological impact. Our objectives were to (a) determine the extent of body image dissatisfaction (BID) in patients with SSc-related telangiectases (b) identify disease-related correlates with telangiectases (c) examine the subjective experiences of patients with telangiectases through qualitative analysis.

Methods:

227 patients aged over 18 years with SSc were invited to participate in a questionnaire survey. Clinical and demographic data was obtained for all participants from a clinical database. Each participant completed the Adjusted Satisfaction with Appearance Scale (ASWAP), the Hospital Anxiety and Depression Scale (HADS) and an open-ended telangiectases questionnaire. Thematic analysis was utilised to describe the qualitative data.

Summary of Results:

141 patients (62%) with SSc responded to the survey (83% female, 70% limited cutaneous SSc, median age 62 years). Telangiectases was reported by 113 (80%). All ASWAP scores (Table 1) were higher in those reporting telangiectases, and this was significant for the 'dissatisfaction with appearance' subscore (p=0.02). Anxiety and depression scores were similar in those with and without telangiectases. Those reporting telangiectases were more likely to be anticentromere positive (40% versus 18%, p=0.02) and to have a history of severe digital ischaemia (38% versus 18%, p=0.04) than those not. Qualitative analysis revealed four themes: changes in behaviour as a result of telangiectases (e.g. social avoidance), public and private self-image (e.g. feeling self-conscious), negative emotional impact of telangiectases (e.g. feelings of sadness or anger) and gaining new perspectives on life (e.g. focusing on positives such as the ability to walk).

Conclusions:

BID, as measured by the ASWAP, was higher in patients with telangiectases, especially within the 'dissatisfaction with appearance' subscale. Telangiectases were associated with anticentromere positivity and digital ischaemia, lending further support for telangiectases as a potential marker for vascular involvement. Qualitative analysis provided new insights into the thoughts and feelings of patients with telangiectases, highlighting concerns and also methods of coping with telangiectases. Our findings highlight the impact of telangiectases and the need to address and manage related concerns.

 All participants n=141Telangiectases n=113No Telangiectases n=28p value (Mann-Whitney U)
ASWAP Social impact, median (IQR)*14 (8–22)14 (8–22)12 (8–20)p=0.67
ASWAAP Dissatisfaction with appearance, median (IQR)*20 (14–26)21 (15–27)15 (12–23)p=0.02
ASWAAP Total score median (IQR)*30 (25–36)37 (27–47)26 (20–41)p=0.09
HADS Anxiety, median (IQR)**7 (4–10)7 (4–10)8 (5–12)p=0.46
HADS Depression, median (IQR)**6 (3–9)6 (3–9)6 (3–8)p=0.52
* 125 subjects.** 240 subjects.

To cite this abstract, please use the following information:
Ennis, Holly, Richards, Helen L., Cassidy, Claire, Herrick, Ariane L.; The Psychological Impact of Systemic Sclerosis-Related Telangiectases. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :1234
DOI: 10.1002/art.29000

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