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The presence of ACAs in people with diffuse cutaneous scleroderma is associated with more gradual onset of skin and organ involvement, according to Joana Caetano from Fernando Fonseca hospital in Portugal and Chris Denton's team from UCL.
ACAs are typically associated with limited cutaneous scleroderma, with a much smaller proportion of those with diffuse cutaneous disease having ACAs. People positive for ACAs are less likely to develop renal crisis or interstitial lung disease, so the researchers analysed 1,313 cases of people with scleroderma who have ACAs. They compared people with ACAs and diffuse scleroderma with 158 people with ACAs and limited cutaneous disease and 258 people without ACAs who had diffuse disease.
Researchers identified a more gradual onset of skin and organ involvement when ACAs were present in people with diffuse cutaneous scleroderma, suggesting that this group has distinct characteristics. The presence of ACA appears to protect against the development of interstitial lung disease and scleroderma-associated renal crisis. It is also associated with better survival than expected in diffuse cutaneous scleroderma.
The researchers, who presented their results in a poster at the British Society of Rheumatology conference, conclude that ACA may modify the characteristics of diffuse scleroderma and that the relationship should be explored further in larger studies.