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Finger Ulcers


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#1 Ron

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Posted 02 April 2015 - 02:19 PM

Hi,

I am a 52 year old male that was diagnosed with Diffuse Scleroderma back in 1987. I developed Raynauds in 1984. I have all the classic symptoms, and some internal organ involvement.

My problem now is an ulcer on my left hand index finger right at the end of the finger, on the corner of the fingernail. It appeared about 2 weeks ago and I usually just leave them as they heal on their own. This one is stubborn. It is very painful when the finger is dry. I tried today using a topical antibiotic and a finger tip bandaid and had no pain whatsoever.

My questioned is what do you do for your ulcers that don't heal they way the normally do.

I do not have a Rheumatologist, as she retired. Any help would be greatly appreciated.

Regards

Ron

#2 Joelf

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Posted 02 April 2015 - 08:52 PM

Hi Ronald,

Welcome to these forums!

I'm sorry to hear that you've been diagnosed with Diffuse Scleroderma and are suffering with painful ulcers. It must be so sore and unfortunately being on your fingers, it's almost impossible to avoid knocking it and further inflaming it.

Thankfully, I've never had ulcers,although I do suffer with Raynaud's,so I can't advise you from my own experience. However, we do have other members who will be able to give you some first hand advice and I've included a link to our medical page on Raynaud's treatments.

As your rheumatologist has retired I've included a link to the Scleroderma Clinical Trials Consortium which I hope will enable you to find a Scleroderma expert in your area. We do recommend that our members, if possible, consult a Scleroderma specialist, as this complex disease does require expert knowledge and expertise.

I'm sorry that you also have internal involvement; we do have extensive information in our Medical pages which I hope you will find interesting and informative.

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#3 Ron

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Posted 03 April 2015 - 04:16 AM

Thank you for your help.



#4 Ron

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Posted 03 April 2015 - 06:04 AM

Has anyone ever been on oral antibiotics for digital ulcers? I have a real bad time with them, I am trying to treat this new ulcer with over the counter topical antibiotics.

Can others please share their experiences?

#5 Shelley Ensz

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Posted 03 April 2015 - 11:44 AM

Hi Ronald,

 

Welcome to Sclero Forums!  You have obviously survived systemic scleroderma for a good 30 years now.  I hope you stick around our forums for many more years as a fine example of good coping and longevity with diffuse scleroderma. 

 

If the ulcers are infected, then oral antibiotics might be necessary.  Keep an eye out for redness around the wound. Fever and/or red streaks going up from it signal an urgent situation (of course).

 

Many things can affect wound healing time, including how we care for the wound, age, stress, other illnesses (such as diabetes) and nutrition.  I'd recommend that you at least see your primary care doctor to discuss wound care, and your options for a new rheumatologist (hopefully, a listed scleroderma expert).

 

With prolonged scleroderma ulcers, the rule of thumb is, "If it's not healing, it's getting worse!"  If it is fairly stable, at two weeks, I wouldn't be quite as concerned as I would at two months.  I had a small toe ulcer that took over a year to heal, that had no infection and no complications.

 

Finger ulcers are the hardest as it is very hard to remember to protect the wound at all times and from all the elements, and to not bump or irritate it.  Sometimes underlying problems need to be addressed for healing (such as optimizing circulation, or diabetic care.) See our section on Digital Ulcers for more info. 

 

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#6 Ron

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Posted 03 April 2015 - 02:06 PM

Thanks for the reply, my problem ulcer is not red, but when I shine a light in it, its shiny in the center, almost like its an open wound. When it dries out its extremely painful, but when I put a topical antibiotic and bandaid on it, the pain goes away. I am trying to treat this myself, that may or may not be the best idea, but doctors here push oral antibiotics and my esophagus and stomach can not handle them, I get a real bad reaction to them. I have another ulcer on my right middle finger, but its just a scab and causes no pain at all, I have had that one for months. Just the new one is causing me grief.

#7 Joelf

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Posted 03 April 2015 - 07:53 PM

Hi Ronald,

I can really understand how loathe you are to take oral antibiotics (I've just had a bout of cellulitis and had to take strong antibiotics, which even upset my lead lined gut!)

As Shelley has said, the ulcer could take a long time to heal and although you don't want to take more antibiotics, I would be inclined to let my doctor check the ulcer out, just in case there is any deep infection. The fact that it's so painful would concern me.

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#8 Ron

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Posted 04 April 2015 - 03:43 PM

Hi,

Thanks for the reply. I went to the drug store and let the pharmacist look at it, she didn't think it was infected, but the side of my finger just by the ulcer is swollen a bit. I am going to try topical antibiotics, if they don't work I will head to the doctors office. The pain was not bad at all today, after putting on the antibiotic and a bandaid before bed, it relieves all of the pain. Its just when it dries out, it become painful. I am typing with that finger and it does not bother me. But I never had an ulcer like this before. Will closely monitor it.

#9 Ron

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Posted 14 April 2015 - 05:51 AM

Is it normal of finger ulcers to get bigger?  The ulcer I have been nursing is getting a bit larger, is this normal?  I am going to the doctor on Thursday.

 

Any comments?



#10 judyt

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Posted 14 April 2015 - 01:12 PM

Yes Ulcers can get bigger.   I don't get finger ulcers but I do get ankle ones.   When I first present myself with a new ulcer the Nurse will usually 'measure' it and make a note of its size.  

 

The aim of course is to see it reduce in size but very often I have to go through the increasing size part before it starts to heal.

 

They can take a very very long time to resolve themselves and I imagine that it is very hard to keep finger ones clean and dry, I wish you luck with that part.

 

Best wishes

Judyt



#11 Kathy D

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Posted 14 April 2015 - 08:32 PM

I am thrilled to hear you are seeing a doc Thurs.  Ulcers can get nasty quickly, nip this one and any future ones in the bud!  And I will echo the others suggesting to keep it covered and clean :)


Diffuse Scleroderma Diagnosed March 2009

#12 Amanda Thorpe

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Posted 15 April 2015 - 01:10 PM

Hello Ronald

 

My foot ulcers have just recently healed, after being open for 4 years, Yep, 4 years! Unfortunately a new area has opened up on the right foot...

 

I am in the UK and had District Nursing coming in quite frequently over the years, now down to once a month at my request. The ulcers have to be dressed and so forth and monitored by a professional. When they were infected they became more painful and well, smelly. The exudate also changed colour, more of a green hue to it, gross eh?

 

My ulcer just closed of their own accord and resulted in the skin breaking down, not because of blood flow and everyone "gave up" on me just leaving me to District Nursing. Believe me I did see just about everyone and I couldn't wear the usual treatment of compression bandages.

 

I have also had an ulcer on my shin after trauma to it and it became my third bout of cellulitis in 5 months, landing me in hospital.

 

If the ulcer does not shift or appears infected I would get medical treatment. Remember that with scleroderma and Raynaud's (I assume you also have this) digital ulcers can progress to infection, gangrene and amputation

 

For people with just Raynaud's, after an attack their blood vessels return to normal but thanks to scleroderma, scarring to our blood vessels can occur making Raynaud's treatment ineffective so we really have to be on top of controlling our Raynaud's and seeking medical attention sooner rather than later.

 

Take care and keep posting.


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#13 Ron

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Posted 15 April 2015 - 02:27 PM

Kathy and Amanda,

I was diagnosed with Raynauds in 1984. In 1987 Scleroderma. In 1992 Diffuse Scleroderma. I have had hundreds of finger ulcers over the years, extremely painful, because I had to work outside in the cold. It gets really cold in the winters here in Canada. Tried an anesthetic cream to deaden the pain, it worked. Since I work inside, since 2009, I still get ulcers but they are more of a nusance now. But this new one that is the largest one I ever had and its growing. I suspect my doctor will give me antibiotic cream. He gave me that for and elbow infection 3 years ago. Over the years more and more of my body is slowly being affected by Scleroderma. My entire GI system, lungs, heart, mouth, gums, thickening skin on parts of my body, etc. My aunt on my fathers side died of Scleroderma about 5 years ago.

For me, I think I am lucky to have had it so long and run a slow course instead of others who decline very quickly. Thanks for everyone's help and experiences.

Ron



#14 Ron

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Posted 17 April 2015 - 08:24 AM

Finger update, went to doctor, he looked at the finger and was going to give me oral antibiotics.  I told him the tough time I have with them so he gave me an antibiotic cream to apply 3 times a day for 10 days. 

 

When I was there I asked him to listen to my lungs, as I was concerned about all the crackling sounds; he could hear abnormalities in both lungs.  So I am going for a chest XRay to have that checked out.  My dad who was 54 when he died of lung cancer from smoking, worries me that it could be cancer, as scleroderma patients are at higher risk of lung cancer.  I don't smoke.  Will let you know the outcome.  I am 52.

Ron



#15 Shelley Ensz

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Posted 21 April 2015 - 09:17 PM

Hi Ron,

 

I'm sorry that you have additional health concerns about cancer.  As it happens, crackling in the lungs is very common with scleroderma lung involvement (pulmonary fibrosis) and even pneumonia. When it comes to noises, it is my understanding that crackles is more likely to be pulmonary fibrosis, and wheezing is more likely to be caused by hayfever, asthma, COPD (etc) and at worst (and less commonly) lung cancer.

 

That said, you are correct, there is an increased risk of cancer in systemic scleroderma; and family history is always concerning. Please keep us posted on your results.

 

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Warm Hugs,

Shelley Ensz
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Hotline and Donations: 1-800-564-7099

The most important thing in the world to know about scleroderma is sclero.org.

#16 Ron

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Posted 25 April 2015 - 04:25 AM

Finger ulcer update:

The ulcer is shaped like an L. It starts at the finger tip and goes around and follows the fingernail half way down.  The tip has scabbed over and no longer painful, the side is still open and painful.  Still on the antibiotic cream, however to me the finger looks like its healing fine.

Lung update,

 

I see the doctor Monday for test results.



#17 Ron

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Posted 07 June 2015 - 05:55 AM

Finger ulcer update, its been 2 months and 3 weeks since I got this nasty finger ulcer. Its 90% healed the help of an antibiotic cream. It worked well, but slow. This was the worst ulcer I have ever had on my fingers.

#18 Shelley Ensz

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Posted 07 June 2015 - 06:37 AM

Hi Ron,

I'm very happy to hear that your finger ulcer is finally on the mend. And I'm eagerly awaiting the post when it's all gone so that we can throw a Sclero Happy Dance. I need the exercise!
Warm Hugs,

Shelley Ensz
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Hotline and Donations: 1-800-564-7099

The most important thing in the world to know about scleroderma is sclero.org.

#19 Ron

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Posted 07 June 2015 - 06:45 AM

LOL, thanks Shelley.

 

Ron



#20 Ron

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Posted 07 June 2015 - 08:20 AM

Well this is not good news:

Digital ulcers predict a worse disease course in patients with systemic sclerosis.

http://www.ncbi.nlm....pubmed/25688073