Related Experiment Video
Updated: Feb 26, 2026
Imaging Features of Systemic Sclerosis-Associated Interstitial Lung Disease
Published on: June 16, 2020
Treatment of digital ulcers in systemic sclerosis: Case series study of thirteen patients and discussion on outcome
Yahia Abuowda1,2, Raquel Sousa Almeida1,2, Ana Alves Oliveira1,2
1Clinic of autoimmune diseases, Department of Internal Medicine - III, Hospital Distrital de Santarém, Santarém, Portugal.
Introduction::
In systemic sclerosis (SSc), digital ulcers (DU) are debilitating and recurrent. They are markers of prognosis and are associated with disability and mortality. Treatment strategies have been developed to block the proposed mechanisms of this complication.
Objective::
Clinical description of a population of SSc patients with DU, treatment, complications and outcome.
Method::
Analysis of 48 SSc patients meeting 2013 ACR-EULAR criteria, followed between 1999-2015; 13 patients had DU. Treatment protocol applied included cycles of 21 days of alprostadil, which can be repeated in the absence of DU healing. After DU healing, bosentan was initiated.
Results::
DU healing was achieved with intravenous prostanoid in 12 patients; seven patients required repeated treatment for DU healing. Twelve patients were later treated with bosentan; three of them experienced recurrence of DU, while one was anti-B2-GPI positive. Four patients had soft tissue loss and three other suffered digital amputation, these being late diagnosis.
Conclusion::
Younger patients and early referrals had better outcomes. Endothelin receptor antagonist toxicity should be monitored, particularly in patients previously exposed to hepatotoxic drugs.
More Related Videos
Related Concept Videos
01:26Varicose Veins II: Diagnostic Studies and Interprofessional Care
01:21Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
01:26Peripheral Artery Disease IV: Nursing Management
01:26Peptic Ulcer Disease IV: Management
The therapeutic approach involves ensuring adequate rest, implementing drug therapy, promoting smoking cessation, making dietary modifications, and emphasizing long-term follow-up care.
Pharmacological management
The prevailing therapy for peptic ulcers involves a combination of managing the patient's current...
01:28Peptic Ulcer Disease III: Clinical Manifestations and Diagnostic Studies
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.
01:27Peripheral Artery Disease III: Interprofessional Care