Best Practice & Research in Clinical Rheumatology最新文献_第3页

IF 4.8 2区医学

Best Practice & Research in Clinical Rheumatology Pub Date : 2026-03-24 DOI: 10.1016/j.berh.2026.102132

Alicia Tran, Lihi Eder

引用次数: 0

A practical clinical approach to the diagnosis and management of morphea (localized scleroderma). 一个实用的临床方法来诊断和管理morphea（局限性硬皮病）。

IF 4.8 2区医学

Best Practice & Research in Clinical Rheumatology Pub Date : 2026-03-20 DOI: 10.1016/j.berh.2026.102127

Caterina Matucci-Cerinic, Dan Lipsker, Clara Malattia, Giorgia Martini

{"title":"A practical clinical approach to the diagnosis and management of morphea (localized scleroderma).","authors":"Caterina Matucci-Cerinic, Dan Lipsker, Clara Malattia, Giorgia Martini","doi":"10.1016/j.berh.2026.102127","DOIUrl":"https://doi.org/10.1016/j.berh.2026.102127","url":null,"abstract":"Morphea, also referred to as localized cutaneous scleroderma, encompasses a heterogeneous group of inflammatory and fibrosing skin disorders characterized by variable depth of tissue involvement and different clinical course. The diagnostic delay remains common due to insidious onset, broad differential diagnosis, and lack of validated biomarkers of disease activity. Clinical assessment relies therefore on expert evaluation, supported by clinical scoring systems and selected imaging techniques. Therapeutic strategies depend on disease subtype, activity, depth, and risk of irreversible damage, ranging from topical agents for limited superficial forms to systemic immunosuppression for deep, linear, generalized, and pansclerotic variants. Methotrexate combined with systemic corticosteroids represents the current first-line systemic therapy, while mycophenolate mofetil and biologics or targeted synthetic agents are increasingly used in refractory disease. This review provides a comprehensive and updated overview of the epidemiology, clinical spectrum, diagnostic approach, and management of morphea across age groups, highlighting recent therapeutic advances, and unmet clinical needs.","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":" ","pages":"102127"},"PeriodicalIF":4.8,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147494713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Definition, diagnosis, treatment for scleroderma primary heart involvement. 原发性心脏受累硬皮病的定义、诊断、治疗。

IF 4.8 2区医学

Best Practice & Research in Clinical Rheumatology Pub Date : 2026-03-20 DOI: 10.1016/j.berh.2026.102134

DeAnna Baker Frost, Ryan J Tedford, Richard Silver

{"title":"Definition, diagnosis, treatment for scleroderma primary heart involvement.","authors":"DeAnna Baker Frost, Ryan J Tedford, Richard Silver","doi":"10.1016/j.berh.2026.102134","DOIUrl":"10.1016/j.berh.2026.102134","url":null,"abstract":"Systemic sclerosis (SSc) is an autoimmune disease characterized by chronic inflammation leading to fibrosis in the skin and organs, including the heart. It is classified as SSc-primary heart involvement (pHI), defined as heart dysfunction primarily caused by SSc, excluding other causes. Several disease manifestations, including conduction abnormalities, cardiac arrythmias, myocarditis/pericardial involvement, heart failure (systolic and diastolic) and valvular dysfunction, are categorized within SSc-pHI. SSc-pHI has a high prevalence, high mortality, and increased risk for sudden cardiac death. Serum biomarkers, high sensitivity troponin and NT-proBNP, may help in screening, with electrocardiography, echocardiography, and Holter monitoring. Cardiac magnetic resonance imaging (cMRI) can confirm SSc-pHI and is considered gold standard for diagnosis, with limited use due to cost and availability. Treatment approaches are multifaceted depending on the manifestation of SSc-pHI but often require immunosuppression at a minimum. A multidisciplinary team including rheumatologists and cardiologists offers the best approach for diagnosis, management, and monitoring.","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":" ","pages":"102134"},"PeriodicalIF":4.8,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147494799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Predicting and preventing clinical psoriatic arthritis. 临床银屑病关节炎的预测与预防。

IF 4.8 2区医学

Best Practice & Research in Clinical Rheumatology Pub Date : 2026-03-20 DOI: 10.1016/j.berh.2026.102133

Enrique R Soriano, Maria Laura Acosta-Felquer, Luis D Mazzuoccolo

引用次数: 0

The promise of imaging in psoriatic arthritis. 银屑病关节炎影像学的前景。

IF 4.8 2区医学

Best Practice & Research in Clinical Rheumatology Pub Date : 2026-03-19 DOI: 10.1016/j.berh.2026.102128

David A Kellner, Illiasul K Ibad, Janeth Yinh, Catherine Bakewell, Erin Chew, Philip Chu, Ann Cameron Barr, Howard H Yang, Madhavi Kandagaddala, Ashish J Mathew, Veena K Ranganath, Gurjit S Kaeley

{"title":"The promise of imaging in psoriatic arthritis.","authors":"David A Kellner, Illiasul K Ibad, Janeth Yinh, Catherine Bakewell, Erin Chew, Philip Chu, Ann Cameron Barr, Howard H Yang, Madhavi Kandagaddala, Ashish J Mathew, Veena K Ranganath, Gurjit S Kaeley","doi":"10.1016/j.berh.2026.102128","DOIUrl":"https://doi.org/10.1016/j.berh.2026.102128","url":null,"abstract":"Psoriatic arthritis (PsA) is a heterogeneous inflammatory disease with variable involvement of peripheral joints, entheses, tendons, soft tissues, and the axial skeleton. While clinical assessment remains central to PsA care, it may be limited in establishing an accurate diagnosis, distinguishing inflammatory disease from common mimics, and fully characterizing disease activity over time. Musculoskeletal ultrasound (MSUS) and magnetic resonance imaging (MRI) provide complementary, noninvasive methods for visualizing inflammatory and structural pathology across these tissue domains. This review summarizes current evidence supporting the use of MSUS and MRI in the diagnosis and management of PsA, with emphasis on clinically relevant applications, and briefly discusses emerging molecular and advanced imaging techniques. We discuss the role of MSUS in early disease detection, differential diagnosis, evaluation of dactylitis and enthesitis, assessment of disease activity and remission, and guidance of treatment decisions in routine practice, and review the role of MRI with a focus on the evaluation of axial involvement and deep inflammatory and structural changes not accessible by ultrasound. Practical considerations, including scanning protocols, contextual factors affecting interpretation, and emerging scoring systems, are highlighted. When integrated with clinical assessment, these imaging modalities improve diagnostic confidence and support longitudinal disease monitoring. Continued advances in imaging methodology and standardization are expected to further refine their role in the care of patients with psoriatic disease.","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":" ","pages":"102128"},"PeriodicalIF":4.8,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147492068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The promise of biomarkers in Psoriatic Arthritis: Moving towards precision medicine. 银屑病关节炎生物标志物的前景：走向精准医学。

IF 4.8 2区医学

Best Practice & Research in Clinical Rheumatology Pub Date : 2026-03-13 DOI: 10.1016/j.berh.2026.102129

Myroslava Kulyk, Kurt De Vlam

{"title":"The promise of biomarkers in Psoriatic Arthritis: Moving towards precision medicine.","authors":"Myroslava Kulyk, Kurt De Vlam","doi":"10.1016/j.berh.2026.102129","DOIUrl":"https://doi.org/10.1016/j.berh.2026.102129","url":null,"abstract":"Psoriatic arthritis is a heterogeneous disease where delayed diagnosis and variable treatment responses remain significant challenges. This review addresses how interconnected metabolic, immunological, and genetic pathways provide opportunities for precision medicine. We examine a distinct metabolic endotype involving altered apolipoproteins and gut metabolites, alongside immunological signatures such as pathogenic tissue-resident memory T cells. Genetic and multi-omic analyses, supported by machine learning, highlight susceptibility loci and signaling pathways that refine disease heterogeneity. Clinically, cytokine profiles and extracellular matrix markers show potential for treatment stratification and monitoring. Furthermore, specific chemokines and inflammatory indices are identified as predictors of the transition from psoriasis to arthritis, enabling early intervention. Integrating these diverse domains through machine learning may facilitate earlier diagnosis and personalized therapy. By defining what is known regarding these biomarkers, this chapter outlines a path toward improved long-term outcomes for patients with psoriatic arthritis.","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":" ","pages":"102129"},"PeriodicalIF":4.8,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147460945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Nailfold capillaroscopy and organ involvement in systemic sclerosis: a systematic review. 系统性硬化症的甲襞毛细血管镜检查与器官累及：系统综述。

IF 4.8 2区医学

Best Practice & Research in Clinical Rheumatology Pub Date : 2026-03-12 DOI: 10.1016/j.berh.2026.102130

C Ickinger, R Campitiello, T Du Four, E Gotelli, E Hysa, R Govender, M Cutolo, V Smith

{"title":"Nailfold capillaroscopy and organ involvement in systemic sclerosis: a systematic review.","authors":"C Ickinger, R Campitiello, T Du Four, E Gotelli, E Hysa, R Govender, M Cutolo, V Smith","doi":"10.1016/j.berh.2026.102130","DOIUrl":"https://doi.org/10.1016/j.berh.2026.102130","url":null,"abstract":"Systemic sclerosis (SSc) is connective tissue disease characterised by early microvascular damage and tissue fibrosis. Nailfold videocapillaroscopy (NVC) enables direct assessment of the microangiopathy and classification into \"scleroderma patterns\", offering potential prognostic value. This systematic review aims to analyse the most updated evidence linking NVC findings with organ-specific involvement in SSc. Uniquely, only longitudinal studies, with centralised reading using the European Alliance of Associations for Rheumatology (EULAR) Study Group on Microcirculation in Rheumatic Diseases consensus framework for nailfold capillaroscopy reporting, and published in the last 10 years were selected. Risk-of-bias assessment was assessed by 3 reviewers using the \"QUality In Prognosis Studies\" (QUIPS) risk-of-bias tool. In total, 14 manuscripts with low to moderate risk of bias were selected and critically analysed. Reduced capillary density (<7 capillaries/mm) and \"Active/Late\" scleroderma patterns, consistently predicted disease progression. Low capillary density and both \"Active\" and \"Late\" scleroderma patterns were strongly associated with more severe skin fibrosis, digital ulcers and calcinosis, pulmonary (arterial) hypertension and interstitial lung disease. A lowered capillary density further predicted major cardiovascular events and gastrointestinal dysmotility, and linked with subclinical renal vasculopathy. In Early SSc, \"Active\" or \"Late\" patterns increased the probability of progression to definite SSc. Finally, reduced capillary density reflects a globally more severe phenotype with worse prognosis. Integrating NVC into routine assessment may enable earlier identification of high-risk patients and promote timely intervention to prevent irreversible organ damage.","PeriodicalId":50983,"journal":{"name":"Best Practice & Research in Clinical Rheumatology","volume":" ","pages":"102130"},"PeriodicalIF":4.8,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147460937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Scleromyositis - The new frontier. 硬化肌炎——新领域。

IF 4.8 2区医学

Best Practice & Research in Clinical Rheumatology Pub Date : 2026-03-06 DOI: 10.1016/j.berh.2026.102126

Marie Hudson, Yves Troyanov, Océane Landon-Cardinal

引用次数: 0

Recent advances in the heart and soul of primary cardiac involvement and cardiovascular disease in systemic sclerosis. 系统性硬化症中原发性心脏受累和心血管疾病的心脏和灵魂研究进展。

IF 4.8 2区医学

Best Practice & Research in Clinical Rheumatology Pub Date : 2026-03-03 DOI: 10.1016/j.berh.2026.102124

Laura Ross, Cosimo Bruni

引用次数: 0

Clinical assessment of Psoriatic Arthritis. 银屑病关节炎的临床评价。