SUMMARY -Were selected 18 SLE patients (ACR criteria) with active cutaneous patients (ACR criteria) with active cutaneous patients (ACR criteria) with active cutaneous patients (ACR criteria) with active cutaneous patients (ACR criteria) with active cutaneous lesions not responsive to chloroquine, photolesions not responsive to chloroquine, photolesions not responsive to chloroquine, photolesions not responsive to chloroquine, photolesions not responsive to chloroquine, photoprotectors and low doses prednisone and who protectors and low doses prednisone and who protectors and low doses prednisone and who protectors and low doses prednisone and who protectors and low doses prednisone and who presented good response to thalidomide but represented good response to thalidomide but represented good response to thalidomide but represented good response to thalidomide but represented good response to thalidomide but relapsed after withdrawal of the drug. All female lapsed after withdrawal of the drug. All female lapsed after withdrawal of the drug. All female lapsed after withdrawal of the drug. All female lapsed after withdrawal of the drug. All female patients had no risk of pregnancy. Thalidomide patients had no risk of pregnancy. Thalidomide patients had no risk of pregnancy. Thalidomide patients had no risk of pregnancy. Thalidomide patients had no risk of pregnancy. Thalidomide was reintroduced and maintained at low dose was reintroduced and maintained at low dose was reintroduced and maintained at low dose was reintroduced and maintained at low dose was reintroduced and maintained at low dose (25-100mg/day) for a minimum of 6 months.

E-selectin is expressed by the activated endothelium and its plasma levels are increased in patients with systemic sclerosis. Eighteen patients fulfilling the American Rheumatism Association criteria for systemic sclerosis, 15 females and 3 males, 42-70 years old, 9 with diffuse and 9 with limited forms, were sequentially recruited for this study. Serum E-selectin levels were determined by commercially available ELISA and their association with nailfold capillaroscopic abnormalities was investigated. Nailfold capillaries were analyzed by 16X magnification wide-field capillaroscopy. Two parameters on capillaroscopy were used to correlate to serum Eselectin: deletion and ectasia. Data were analyzed statistically by the Student t-test and Spearman correlation. Two-tailed P values below 0.05 were considered significant. E-selectin range was 38 to 200 ng/ml (80 ± 39.94). There was a correlation between serum Eselectin levels and the deletion capillaroscopic score (r = 0.50, P < 0.035). This correlation was even stronger within the first 48 months of diagnosis (r = 0.63, P < 0.048). On the other hand, no association was observed between selectin and ectasia. Patients with diffuse disease presented higher serum E-selectin levels than patients with limited disease, although the difference was not statistically significant (96.44 ± 48.04 vs 63.56 ± 21.77 ng/dl; P = 0.08). The present study is the first showing a correlation between soluble serum E-selectin levels and alterations in capillaroscopy. The stronger correlation of deletion score in capillaroscopy in early disease suggests that serum E-selectin levels might be a useful biochemical marker of disease activity in systemic sclerosis. Correspondence

INTRODUÇÃOO envolvimento ósseo, em pacientes com esclerodermia sistêmica, caracteriza-se, geralmente, por reabsorção óssea, predominantemente das extremidades das falanges distais dos dedos das mãos e, mais raramente, dos pés e outras partes do esqueleto [1][2][3] . Também, já foi descrito, em pacientes com esclerodermia, principalmente em mãos, osteopenia localizada periarticular, que, nos estágios mais tardios da doença, pode estender-se por todo o membro comprometido [4][5][6] . A observação inicial, associando osteopenia generalizada à esclerodermia, foi feita por Serup et al.