• A Achille, L Journeau, O Espitia, J Connault, A Espitia-Thibault, C Durant, F Perrin, M-A Pistorius, A Néel, M Hamidou, and C Agard.
• Centre de compétences maladies systémiques et auto-immunes rares, pôle hospitalo-universitaire 3, service de médecine interne, hôpital Hôtel-Dieu, place Alexis-Ricordeau, 44093 Nantes cedex 1, France.
• Ann Dermatol Vener. 2018 Mar 1; 145 (3): 166-172.

BackgroundThe aim of this study was to describe special features of patients with systemic sclerosis (SSc) diagnosed after the age of 70.Patients And MethodsThis is a retrospective study of patients aged above 70 years at the time of diagnosis of SSc and followed at an internal medicine unit between 2000 and 2015. Co-morbidities and clinical characteristics were analyzed, as well as survival at 1, 2 and 3 years.ResultsOf 246 patients, 27 (11%) were included (89% women, 96% Caucasians, age 78.3±4.5 years). Synchronous cancer was noted in 3 patients. SSc was mostly limited cutaneous only (24/27), with telangiectasia (63%), gastroesophageal reflux (59%) and digital ulcers (22%), and was associated with anti-centromere antibody (69%). Interstitial lung disease was not frequent (29%). Pulmonary arterial hypertension (PAH) was suspected at diagnosis of SSc in 14 cases (52%), but only 5 patients had undergone heart catheterization, with severe PAH in 3 cases. Survival at 1 and 3 years was 85.2% and 66.7%, and was worse in the case of suspected PAH, at 78.6% and 57.1% respectively.ConclusionCases of SSc diagnosed after 70 years are mostly limited cutaneous forms. Suspicion of PAH is frequent, and PAH may be the main initial sign of the disease for patients at this age. There may be association with synchronous cancer. Survival is poor.Copyright © 2017 Elsevier Masson SAS. All rights reserved.

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