No association of atherosclerosis with digital ulcers in Japanese patients with systemic sclerosis: Evaluation of carotid intima‐media thickness and plaque characteristics

Patients with systemic sclerosis ( SS c) usually develop Raynaud's phenomenon, persistent digital ischemia and sometimes develop digital ulcers ( DU ). Several studies have reported an association of carotid artery atherosclerosis with SS c by evaluating carotid intima‐media thickness ( IMT ) in SS c patients. However, none of those studies analyzed the association between DU and carotid artery atherosclerosis in SS c patients. We examined the association of carotid artery atherosclerosis with digital ulcers by comparing SS c patients with ( n  = 48, 29.5%) and without ( n  = 206, 70.5%) DU . The demographic and clinical features of the SS c patients showed that young age, male sex, anti‐topoisomerase I antibody positivity, severe skin sclerosis, interstitial lung disease complication and cardiac involvements were significantly prevalent in patients with DU . In addition, diffuse cutaneous type, anti‐ RNA polymerase III antibody positivity and severe skin sclerosis are more frequent in SS c patients with DU at the extensor surface of joints than SS c patients with DU at the digital tip. There were no differences in serum lipid level, carotid IMT or plaque score between SS c patients with and without DU , suggesting that atherosclerotic changes are not primarily involved in the development of DU .