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Digital ulcers in systemic sclerosis.

Michael Hughes1, Ariane L Herrick2,3

  • 1Centre for Musculoskeletal Research, The University of Manchester, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester michael.hughes-6@postgrad.manchester.ac.uk.

Rheumatology (Oxford, England)
|April 21, 2016
PubMed
Summary
This summary is machine-generated.

Digital ulcers (DUs) in systemic sclerosis (SSc) significantly impact quality of life and indicate disease severity. Effective management requires a multifaceted approach, including patient education, lifestyle changes, and pharmacological therapies.

Keywords:
digital ulcerssclerodermasystemic sclerosis

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Area of Science:

  • Rheumatology
  • Vascular Medicine
  • Dermatology

Background:

  • Digital ulcers (DUs) are a common manifestation of systemic sclerosis (SSc), reflecting progressive vascular disease.
  • DUs negatively affect patient quality of life and hand function, serving as biomarkers for internal organ involvement and disease severity.

Purpose of the Study:

  • To review the spectrum of digital ulcer disease in SSc.
  • To discuss pathophysiology, epidemiology, and clinical burden of DUs in SSc.
  • To inform a multifaceted management approach for DUs in SSc.

Main Methods:

  • Literature review of SSc pathophysiology, epidemiology, and clinical manifestations related to DUs.
  • Analysis of current therapeutic interventions for DU prevention and treatment.
  • Discussion of the role of DUs in SSc classification and clinical trials.

Main Results:

  • The etiology of SSc-related vascular disease is multifactorial with potential therapeutic targets.
  • Management strategies include patient education, non-pharmacological interventions (e.g., smoking cessation), and drug therapies (e.g., PDE-5 inhibitors, ET receptor antagonists, i.v. iloprost).
  • DU assessment reliability among rheumatologists is a challenge in clinical practice and research.

Conclusions:

  • Digital ulcers are critical indicators of systemic sclerosis severity and progression.
  • A comprehensive management strategy integrating patient education, lifestyle modifications, and pharmacotherapy is essential.
  • Further research is needed to improve the reliability of DU assessment in clinical practice and research settings.