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[Fast and efficient healing of scleroderma-associated acral ulcers with sildenafil].

E Friedrichson¹, P Rehberger, J T Fuhrmann

¹Klinik und Poliklinik für Dermatologie, Medizinische Fakultät der Technischen Universität Dresden, Dresden.

Der Hautarzt; Zeitschrift Fur Dermatologie, Venerologie, Und Verwandte Gebiete

|July 10, 2007

Summary

Sildenafil effectively healed severe, treatment-resistant acral ulcers in a progressive systemic sclerosis patient. This phosphodiesterase-5 inhibitor improved pulmonary arterial hypertension symptoms and walking ability.

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Area of Science:

Vascular Medicine
Rheumatology
Pharmacology

Background:

Progressive systemic sclerosis (PSS) frequently causes debilitating acral ulcers, often resistant to standard treatments.
Pulmonary arterial hypertension (PAH) is a severe complication of PSS, contributing to patient morbidity.

Observation:

A 35-year-old male with severe PSS, PAH, and refractory acral ulcers was treated with oral sildenafil.
Sildenafil, a phosphodiesterase-5 inhibitor, enhances endothelial cGMP, promoting vasodilation.

Findings:

The patient experienced rapid improvement in dyspnea and increased walking distance within one week of sildenafil administration.
Complete and sustained healing of all acral ulcers was achieved within five weeks of treatment.
Sildenafil demonstrated significant efficacy in managing scleroderma-associated refractory acral ulcers.

Implications:

Sildenafil represents a promising therapeutic option for refractory acral ulcers in patients with progressive systemic sclerosis.
This case highlights the potential of targeting phosphodiesterase-5 pathways for managing complex vascular complications in autoimmune diseases.
Further research into sildenafil's role in PSS management, particularly for vascular and dermatological manifestations, is warranted.