Evidence map›Paper›PMID 39302703›Full record

ArticleRheumatology (Oxford, England)2025

Colour changes in the feet: a sign of autonomic symptoms in systemic sclerosis.

Brittany L Adler, Kamini Kuchinad, Seeun Judy Jeong, Lauren E Stiles, Ami A Shah, Tae Chung, Zsuzsanna H McMahan

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Rheumatology (Oxford, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Brittany L AdlerDivision of Rheumatology, Johns Hopkins University, Baltimore, MD, USA.ORCID 0000-0001-9912-2435
Kamini KuchinadDivision of Rheumatology, Johns Hopkins University, Baltimore, MD, USA.
Seeun Judy JeongDepartment of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD, USA.
Lauren E StilesDepartment of Neurology, Stony Brook University Renaissance School of Medicine, Stony Brook, NY, USA.
Ami A ShahDivision of Rheumatology, Johns Hopkins University, Baltimore, MD, USA.
Tae ChungDepartment of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD, USA.
Zsuzsanna H McMahanDivision of Rheumatology, Department of Internal Medicine, The University of Texas Health Science Center at Houston, Houston, TX, USA.ORCID 0000-0001-6461-8940

Funding

Sample Processing and Immunoassay Research CoreP30AR070254 · NIAMS · JOHNS HOPKINS UNIVERSITY · PI Antony Rosen · 2016 to 2026
$8.9M
Multidisciplinary Rheumatology Training ProgramT32AR048522 · NIAMS · JOHNS HOPKINS UNIVERSITY · PI CLIFTON O BINGHAM, LIVIA A CASCIOLA-ROSEN · 2003 to 2026
$6.4M
Interrogating the pathophysiological mechanisms of constipation in patients with systemic sclerosisR01AR081382 · NIAMS · UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON · PI Jiande Chen, Zsuzsanna Hortobagyi McMahan · 2023 to 2026
$2.4M
Harnessing multivariate patient- and population-level disease trajectories to predict major clinical events in sclerodermaK24AR080217 · NIAMS · JOHNS HOPKINS UNIVERSITY · PI Ami Aalok Shah · 2022 to 2026
$847k
Chresanthe Staurulakis Memorial Discovery FundDonald B and Dorothy L Stabler FoundationJohns Hopkins inHealth initiativeNIAMS NIH HHS K24 AR080217NIAMS NIH HHS P30 AR070254NIAMS NIH HHS R01 AR081382NIAMS NIH HHS R01AR081382-01A1NIAMS NIH HHS T32 AR048522
6 · The paper itself

Abstract

objectivesPatients with autonomic dysfunction, or dysautonomia, often report discolouration of their dependent extremities, which is thought to be from venous pooling or acrocyanosis. A subset of patients with SSc are affected by dysautonomia but may be challenging to identify. We sought to determine whether patients with SSc who report discolouration in their feet have a higher burden of autonomic symptoms, including orthostatic, gastrointestinal (GI), urinary, secretomotor and pupillomotor.

methods167 patients with SSc completed the Composite Autonomic Symptom Score (COMPASS)-31 survey, which queries whether the patient experiences discolouration of the feet or hands. We compared the COMPASS-31 subdomain scores between SSc patients with and without foot discolouration. Seventy-nine patients with postural orthostatic tachycardia syndrome (POTS) also completed the COMPASS-31 questionnaire for comparison.

resultsWe found that extremity discolouration is common in POTS and more often affects the feet, whereas in SSc, the hands are more frequently involved; 62% of SSc patients report colour changes in their feet. These patients are more likely to have other autonomic symptoms, including orthostatic (11.7 ± 10.6 vs 8.6 ± 9.9, P = 0.06), GI (11.3 ± 4.3 vs 8.8 ± 4.3, P = 0.0003), urinary (1.4 ± 1.5 vs 0.8 ± 1.3, P = 0.002) and secretomotor (7.0 ± 3.8 vs 5.9 ± 3.8, P = 0.06) symptoms. These associations persist in a multivariable model after adjusting for potential confounders.

conclusionDependent extremity discolouration is common in dysautonomia. Patients with SSc who report colour changes in their feet are more likely to report other symptoms of autonomic dysfunction.

Indexed as

Autonomic Nervous System DiseasesFootPrimary DysautonomiasScleroderma, SystemicAdultAgedColorFemaleHumansMaleMiddle AgedPostural Orthostatic Tachycardia SyndromeSurveys and QuestionnairesacrocyanosisCOMPASS-31dysautonomiaRaynaud’ssclerodermaSSc

Identifiers

PMID39302703
PMCPMC12048065

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.