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Objectives Patients with systemic sclerosis (SSc) have some musculoskeletal manifestations. The radiologic manifestations can be articular or non-articular. There is inconsistency in the correlation between clinical manifestations and radiologic changes; there are few reports on the correlation between them and capillaroscopy. Material and Methods We evaluated 81 patients with SSc, using a cross- sectional single center study, referred to scleroderma clinic affiliated to Shiraz University of Medical Sciences, Iran. Skin score and capillaroscopy were performed and an expert radiologist did the radiologic evaluation of the posterior-anterior views of both hands and wrists. For data analysis, SPSS version 19 was used.Results The participants consisted of 73 women and eight men aged 42±2.6 years old. There were 60.5% limited scleroderma (lcSSc) and 39.5% diffuse scleroderma (dcSSc) patients. After 5 years, 91% of them had some radiologic changes mostly asymptomatic.The most common radiologic changes were non-articular (70.1%), including acro-osteolysis, subcutaneous and peri-articular calcinosis and avascular necrosis. Flexion deformities and DIP joint space narrowing were more seen in patients with dcSSc. Resorption of the distal ulna and avascular necrosis was observed more in lcSSc. There was a correlation between radiologic changes and duration, but not with the skin score. The most common capillaroscopic pattern in patients with radiologic change was late scleroderma pattern.Conclusions Radiologic changes which were mostly asymptomatic were common in patients with SSc. The changes were different in patients with dcSSc and lcSSc and there were associations with duration and capillaroscopic patterns, but not with the skin score.

Objectives: Investigating the sexual dysfunction in scleroderma patients and its relation to their vascular involvements. Method: A case control study was done on 80 married female scleroderma patients with age between 20-60 years old. Eighty normal individuals adjusted for age, place of living and socioeconomic status were also recruited. Sexual performance in both groups was assessed using FSFI standardized questionnaire, which evaluated it in 6 domains of desire, arousal, lubrication, orgasm, satisfaction, and pain. Micro and macro-vascular involvements of the patients were also determined using Raynaud Condition Score, Echocardiography, physical exam for assessing their digital ulcers and reviewing their medical records for past or present history of renal crisis and thromboembolic events. Results: The total score of FSFI in the case group was significantly lower compared to control one (16.68 ± 6.35, 19.69 ± 6.01, P-value

Aim: Assessing the effect of Diltiazem gel on scleroderma digital ulcers compared to Nitroglycerin ointment and placebo. Methods: A single blind randomized controlled trial was done on 90 scleroderma patients, randomly divided to three groups: one receiving Diltazem gel 2%, the other receiving Nitroglycerin ointment 2% and control one receiving Vaseline as placebo for 2 times per day for 8 weeks. The patients' demographic information and disease characteristics were summarized. The longest diameter of the ulcers was measured in 3 groups at the beginning and at the end of the study. The site of the ulcers and the number of new ones were, also, determined for each patient Results: The effect size of the ulcers, in each three groups, was significantly lower at the end of the survey (Diltiazem P

Systemic lupus erythematosus (SLE) is considered one of the risk factors for cervical cytological abnormalities and high-risk HPV infection. However, there is a scarcity of data about the prevalence of high-risk HPV infection in patients with lupus. In order to define strategies for cancer prevention, we aimed to determine the prevalence of HPV infections in women with SLE compared to a control group. Fifty patients with SLE from the SLE clinic in Hafez Hospital, Shiraz University of Medical Sciences, were compared to 50 healthy married control women. In both groups, routine Pap smears were obtained, and the endocervical side of the spatula was sent for HPV DNA analysis. The case and control groups were compared for the presence and type of HPV infection as well as the relation between its presence with immunosuppressant use and disease activity. HPV infection was detected in 4% (2.50) of lupus patients, but it was not seen in the control group. HPV typing identified types 16 and 18 in these two patients. No relationship between HPV infection and immunosuppressant use or activity of disease was seen in the current study. There was no statistically significant difference in HPV prevalence between patients and the control group (P=0.495). Results of this study showed that SLE and the use of immunosuppressants in patients with lupus were not risks for high-risk HPV infection or cervical dysplasia in our area compared to the normal population, but further studies on more patients receiving immunosuppressants and biologics are recommended.

This study aimed to determine the serum levels of prolactin and dehydroepiandrosterone (DHEA) in systemic sclerosis (SSc) and their correlation with disease duration and clinical manifestations. This case control study investigated 26 scleroderma patients and 26 healthy individuals adjusted for age and sex with the case group as controls. Serum levels of DHEA using radioimmunoassay (RIA) and prolactin using immune radiometric assay (IRMA) were measured in both groups. Clinical manifestations of the disease, disease duration, and fertility status at the time of the study were also determined for each scleroderma patient. The findings on 26 scleroderma patients (20 females and 6 males with mean age of 44 years and mean disease duration of 5±3 years) demonstrated that serum levels of DHEA were significantly lower in scleroderma patients than controls based on gender (males, p= 0.02) and fertility (fertile women, p= 0.01; menopausal women, p= 0.008). However, no significant difference was found in prolactin serum levels between the case and control groups. Moreover, only serum PRL levels correlated significantly with disease duration in fertile women. Contrary to previous studies, this study manifested that serum PRL did not differ between scleroderma patients and normal individuals. Yet, serum DHEA was shown to be significantly lower in scleroderma patients. Only PRL levels correlated significantly with disease duration.