The number of telangiectasia might be considered a complementary biomarker to the presence of vascular complications of SSc including PAH, DU and calcinosis.
Key Findings
Results
Higher telangiectasia counts over the face and hands were associated with higher prevalence of calcinosis, digital ulceration, and pulmonary arterial hypertension in univariate analysis.
Associations were found between telangiectasia counts at face and hands with calcinosis, digital ulceration (DU), and pulmonary arterial hypertension (PAH)
Statistical significance was reported as P < 0.001–0.003 in univariate analysis
Study design was a retrospective analysis of a large, cross-sectional international SSc-related vasculopathy study
Telangiectasia counts were assessed in three anatomical sites: face, forearms, and hands
Counts were categorized as 0, 1–6, 7–15, or >15 telangiectasia
Results
In multivariate analysis, the presence of PAH, digital ulceration, and calcinosis were each independently associated with higher facial telangiectasia counts.
All three associations (PAH, DU, calcinosis with facial telangiectasia) reached statistical significance at P < 0.05 in multivariate analysis
Analysis was performed using proportional odds logistic regression
Multivariate analysis controlled for other disease characteristics and demographics
Facial telangiectasia emerged as the most consistently significant site in multivariate modeling
Results
A binary logistic regression model for detecting co-existent PAH was enhanced by the inclusion of telangiectasia count and site.
Area under the precision recall curve improved to 0.824–0.875 when telangiectasia count and site were included in the PAH detection model
The model examined the value of telangiectasia counts on the accuracy of identifying co-existent PAH
Both telangiectasia count and anatomical site contributed to model enhancement
This suggests telangiectasia quantification adds discriminatory value beyond existing clinical variables for PAH identification
Results
Agreement between clinician- and patient-reported telangiectasia counts was moderate for the face and forearms, and relatively weaker for the hands.
Kappa for face concordance was 0.648 (P < 0.001)
Kappa for forearm concordance was 0.605 (P < 0.001)
Kappa for hand concordance was 0.584 (P < 0.001), described as 'relatively weaker'
Concordance was tested between clinician- and patient-reported counts at each of the three anatomical sites
The authors concluded that anatomical regions and level of instruction for patient-reported counts need further optimization to be considered reliable and feasible
Background
Telangiectasia are a common feature of systemic sclerosis and the study investigated both site-specific and quantitative relationships with vascular disease markers.
The study was a retrospective analysis of a large, cross-sectional international SSc-related vasculopathy study
Clinician and patient assessments of telangiectasia counts were both collected and compared
Three anatomical sites were assessed: face, forearms, and hands
Both proportional odds logistic regression and binary logistic regression were used as analytical approaches
The authors note future work should consider correlations with nailfold capillaroscopic patterns
What This Means
This research suggests that counting telangiectasia — the small, dilated blood vessels visible on the skin surface commonly called 'spider veins' — may provide clinically useful information about the severity of vascular disease in people with systemic sclerosis (SSc), a chronic autoimmune disease that affects the skin and internal organs. The study found that patients with more telangiectasia, particularly on the face, were more likely to have serious vascular complications including pulmonary arterial hypertension (high blood pressure in the lungs), digital ulcers (sores on the fingers), and calcinosis (calcium deposits in the skin). When telangiectasia counts were added to a statistical model for identifying pulmonary arterial hypertension, the model's accuracy improved substantially, suggesting that this simple skin observation could complement existing diagnostic tools.
The study also tested whether patients could reliably count their own telangiectasia compared to clinician counts. Agreement between patient and clinician counts was moderate for the face and forearms, but somewhat weaker for the hands, suggesting that while patient self-reporting shows promise, the instructions and anatomical regions used for self-assessment need further refinement before this approach can be considered fully reliable for clinical or research use.
Overall, this research suggests that the simple act of counting telangiectasia at specific body sites — particularly the face — could serve as an accessible, non-invasive biomarker to help identify patients with systemic sclerosis who are at higher risk of serious vascular complications. Incorporating telangiectasia quantification into routine clinical assessments or patient self-monitoring tools could potentially support earlier detection of disease progression, though further studies are needed to optimize measurement methods and to explore how telangiectasia counts relate to other vascular assessments such as nailfold capillaroscopy.
Wells M, Smith T, Domsic R, Anilkumar A, Frech T, Herrick A, et al.. (2026). The clinical utility of telangiectasia quantification as markers of vascular disease progression in systemic sclerosis.. Rheumatology (Oxford, England). https://doi.org/10.1093/rheumatology/keag267