| SKIN INVOLVEMENT: MAIN MENU |
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Digital (Finger or Toe) Ulcers |
| This page was written by Shelley Ensz, and has not yet been medically edited. Scleroderma (SD) affects everyone differently. Just because something is listed here does not mean an individual patient will ever experience it. See Disclaimer. |
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| What are Digital Ulcers? |
| Systemic scleroderma and Raynaud's can cause painful ulcers on the fingers or toes, which are known as digital ulcers. |
 Most people try several methods of dealing with finger ulcers before settling on the system that works best for them.
But remember, no treatment for finger ulcers should be undertaken without the supervision of a physician — it's very important to treat finger ulcers properly, to prevent complications such as serious infection, gangrene or possible amputation. |
| A 3-factor epistatic model predicts digital ulcers (DU) in Italian scleroderma patients. Biological interpretation via Petri net showed that IL-6 is a key factor in determining digital ulcers (DUs) occurrence and that this cytokines may synergise with HLA-B*3501 to determine DUs onset. Lorenzo Beretta. European Journal of Internal Medicine Volume 21, Issue 4, Pages 347-353 (August 2010). |
| Digital Lesions (DL) in Systemic Sclerosis (SSc): Evidence for a New Classification of Digital Ulcers (DU). DL are mainly represented by Digital pitting scars, DU and calcinosis. The patient follow up has allowed a morphological DU classification with the definition of the main DU characteristics, of DU pain and staging. This classification may be helpful in practice and in future RCTs for a precise identification of those DU that are to be included or excluded in specific therapeutic studies. F. Braschi. [THU0326] EULAR 2009. |
| Stress dramatically slow wound healing! |
Stress Slows Wound Healing. Because researchers found that wounds heal slower and are at greater risk of infection during stressful times. Christopher G. Engeland, PhD. Bottom Line Secrets. 07/19/09. (Also see: Causes of Scleroderma: Stress) |
| Impact of digital ulcers on disability and health-related quality of life in systemic sclerosis (SSc). SSc patients with Digital Ulcers have reduced wrist and hand mobility, increased global and hand disabilities and decreased mental component of Health Related Quality of Life. Luc Mouthon. Ann Rheum Dis. 16 February 2009. |
| Biomarkers of vascular disease in scleroderma. Vascular disease is present in every patient with scleroderma and is a major source of morbidity and mortality. There is a subset of patients who will develop severe and sometimes life-threatening vascular events. (PubMed) Hummers LK. Rheumatology (Oxford). 2008 Oct;47 Suppl 5:v21-2. (Also see: Vascular Disease and Pulmonary Hypertension) |
| Lack of agreement between rheumatologists in defining digital ulceration in systemic sclerosis. Thirty-five images of finger lesions, incorporating a wide range of abnormalities at different sites, were duplicated, yielding a data set of 70 images. The poor interrater reliability suggests that if digital ulceration is to be used as an end point in multicenter clinical trials of SSc, then strict definitions must be developed. Herrick AL. (PubMed) Arthritis Rheum. 2009 Feb 26;60(3):878-882. |
| Blunted increase of digital skin vasomotion following acetylcholine and sodium nitroprusside iontophoresis in systemic sclerosis (SSc) patients. This study showed a selective abnormality of the endothelial, sympathetic and myogenic-dependent finger skin vasomotion in SSc patients, consistent with a parallel endothelial, sympathetic and myogenic macrovascular dysfunction. M. Rossi. Rheumatology. April 22, 2008. (Vasomotion is cyclic variation in vascular diameter) (Also see: Raynaud's) |
| Clinical burden of digital vasculopathy in limited and diffuse cutaneous systemic sclerosis. Digital vasculopathy is a serious complication of SSc contributing significant morbidity and often requiring hospital-based management. Nihtyanova SI. (PubMed) Ann Rheum Dis. 2008 Jan;67(1):120-3. |
| Natural History of Ischemic Digital Ulcers (DU) in Systemic Sclerosis: Single-Center Retrospective Longitudinal Study. Development of DU typically occurred within 5 years of the first non-Raynaud clinical symptom of SSc in the majority of patients. J Rheumatol 2007;34:2423-30. |
| Hand vascular involvement assessed by magnetic resonance angiography in systemic sclerosis. Impairment of the microcirculation is a cardinal feature of systemic sclerosis (SSc). Magnetic resonance angiography (MRA) has improved the assessment of vascular lesions of the hand. The aim of this study was to evaluate vascular abnormalities in the hands of patients with SSc, using MRA. (Wiley InterScience) Arthritis & Rheumatism.Volume 56, Issue 8, Pages 2747 - 2754. July 30 2007. (Also see: Raynaud's) |
| Abnormal microvascular response is localized to the digits in patients with systemic sclerosis (SSc). This study suggests that SSc has no effect on microvascular perfusion in the dorsum of the hand, and that the abnormal microvascular response is localized to the digits, affecting both smaller and larger vessels. Arthritis & Rheumatism Journal. Vol 54, Issue 6:1952 - 1960 June 2006. (Also see: Raynaud's) |
| Capillaroscopy for Digital Ulcers |
| Capillaroscopic skin ulcer risk index: A new prognostic tool for digital skin ulcer development in systemic sclerosis (SSc) patients. The early detection of SSc patients who are at high risk to develop digital ulcers could allow a preventive treatment of these complications with reduction of morbidity and social costs. The aim of our study was to develop a capillaroscopic skin ulcer risk index (CSURI) that can predict the onset of new digital ulcers by using nailfold videocapillaroscopy (NVC) in patients with SSc. M. Sebastiani.(UnBound) Arthritis Rheum 2009 Apr 29; 61(5):688-694. |
| Correlation of a Quantitative Videocapillaroscopic Score with the Development of Digital Skin Ulcers in Scleroderma (SSc) Patients. This capillaroscopic score may represent a feasible and simple tool in SSc patients' assessment. The routinely use of this parameter might permit to recognize and to preventively treat SSc patients at high risk to develop digital ulcers. M. Sebastiani. SAT0222. EULAR 2008. |
| Photos of Digital Ulcers |
 Digital (Finger) Ulcers Scleroderma and Raynaud's can cause painful ulcers on the fingers or toes, which are known as digital ulcers. No treatment for finger ulcers should be undertaken without the supervision of a physician — it's very important to treat finger ulcers properly, to prevent complications such as serious infection, gangrene or possible amputation. ISN Photo Repository, contributed by Cindy G. |
 Digital (Finger) Ulcer from Mixed Connective Tissue Disease (MCTD). This digital ulcer is 14 weeks old. It was caused by secondary Raynaud's phenomenon, in a patient with Mixed Connective Tissue Disease (MCTD). The MCTD was diagnosed 5 years ago, after thyroid gland removal. ISN Photo Repository, contributed by Jeanne N. |
| Digital Ulcer from Mixed Connective Tissue Disease (MCTD). When I was eighteen my rheumatologist diagnosed me with rheumatoid arthritis. Later at the age of twenty-one, another doctor said it looks more like C.R.E.S.T. Scleroderma. Now I'm twenty-six and the same doctor who diagnosed me with rheumatoid arthritis says its mixed connective tissue disease (MCTD). ISN Photo Repository, contributed by Rosemarie. |
 Photo of Leg Ulcer This is a very large chronic leg ulcer in a Systemic Sclerosis patient, which has not responded to treatment. ISN Photo Repository, contributed by Sylvia Finegan. |
| Treatments |
| The best treatment for digital ulcers is to prevent them from occurring in the first place. Since many digital ulcers are directly related to frequent Raynaud's episodes, it is important to follow the Raynaud's prevention techniques the help to reduce Raynaud's episodes and intensity. |
| It cannot be emphasized enough that scleroderma finger ulcers are not a do-it-yourself project. Do not attempt any of the ideas listed here (or elsewhere on the Internet) without consulting your doctor first. |
| Management of cutaneous vascular complications in systemic scleroderma: experience from the German network. Management of Raynaud's Phenomenon and ulcerations in SSc were heterogeneous at initiation of the network, reflecting a sometimes insufficient use of the diagnostic and therapeutic possibilities. (PubMed) Rheumatol Int. 2008 Mar 5. (Also see: Raynaud's) |
| Exercise may play role in reducing inflammation in damaged skin tissue. “The key point of the study is that moderate exercise sped up how fast wounds heal in old mice,” said researcher K. Todd Keylock, who noted that the improved healing response “may be the result of an exercise-induced anti-inflammatory response in the wound.” News Bureau, University of Illinois 11/28/07. |
| Wound Care Centers |
| Many times Scleroderma skin ulcers are treated at wound care centers. Follow your doctor's advice carefully for healing wounds. And remember this rule of thumb: |
"If it has not started healing in a month,
it's not healing — it's getting worse!" |
| Alternative Treatments |
| Assessment of the antimicrobial properties of maggots. Complete lysis of the bacterial or fungal cultures in the area of maggot application provides convincing evidence for the antimicrobial property of maggots. This effect has a significant implication in management of diabetic foot ulcers and vascular ulcers. Margolin L. (PubMed) Int Wound J. 2010 Apr 23. |
| Ancient Healing Power: Honey Makes Sweet Comeback In Treating Advanced Wounds. Clinical studies of MEDIHONEY™ have shown it has promise over current treatments because of its strong wound healing benefit. Medical News Today. 10/24/07. |
| Effect of Clonazepam on Raynaud's Phenomenon and Fingertip Ulcers in Scleroderma. We report a case of Raynaud's phenomenon and digital ulcers responding to clonazepam. Further research is warranted to test the robustness of this preliminary finding. The Annals of Pharmacotherapy: Vol. 41, No. 9, pp. 1544-1547. 2007. (Also see: Raynaud's) |
| Antibiotics |
| Antibiotics are sometimes necessary for the treatment of digital ulcers. |
| Apligraf |
| On 5-26-98, the FDA approved Apligraf, a new interactive wound dressing, for treatment of skin ulcers which are caused by insufficient blood flow. ApliGraf is made out of living, human cells, so its all-natural and never has to be removed after application. |
| Amputation |
| Gangrene (Death of Tissue) and Amputation. Digital ulcers can develop gangrene and lead to amputation. Thus Raynaud's prevention and prompt and careful treatment of digital ulcers is absolutely essential. ISN. |
| Prevention of amputation caused by rheumatic diseases following a novel therapy of exposing bone marrow, occlusive dressing and subsequent epidermal grafting. Exposure of bone marrow cells plus an occlusive dressing accelerates the healing of skin ulcers. PubMed. Br J Dermatol. 2005 Apr;152(4):664-72. (Also see: Gangrene and Amputation) |
| Bosentan, Tracleer, Endothelin Receptor Antagonist (ERA) |
| Scleroderma Treatments: Bosentan. Digital ulcers in patients with systemic sclerosis (scleroderma) can be prevented and treated with bosentan. In addition, it appears to be effective for many other symptoms of systemic scleroderma. Bosentan is in a class of drugs called endothelin receptor antagonists by preventing an overproduction of endothelin. ISN. |
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| Tracleer® (Bosentan) Receives New Indication In Patients With Systemic Sclerosis And Active Digital Ulcer Disease. Actelion Pharmaceuticals UK Ltd announced that Tracleer® (bosentan), a dual endothelin receptor antagonist, has been approved in the UK and Ireland for the reduction of the number of new digital ulcers (DUs) in patients with systemic sclerosis (SSc) and ongoing DU disease. Medical News Today. 04/28/08. (Also see: Bosentan) |
| Long-term experience of bosentan for treating ulcers and healed ulcers in systemic sclerosis patients. Bosentan may be a safe long-term alternative for treating the recurrence of skin ulcers and healed ulcers in SSc patients. Rheumatology 2008 47(4):464-466. (Also see: Bosentan) |
| Botox (Botulinum Toxin) |
| Botulinum Toxin Type A (BTX-A): A Treatment Option for Digital Ischemia in Patients With Raynaud's Phenomenon. BTX-A was found to be a safe and useful treatment option for vasospastic digital ischemia. (Unbound Medline) A. Fregene. J Hand Surg. March 2009. (Also see: Raynaud’s Treatments) |
| Creams and Solutions |
| Generic Names |
Brand Names |
| povidone-iodine solution |
Betadine Solution ® |
| sodium hypochlorite-diluted |
Dakin's Solution ® |
| hydrogen peroxide solution (1.5%-3.0%) |
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| silver sulfadiazine cream |
Silvadene ®. |
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| Treatment of Ischemic Ulcers in Patients with Systemic Sclerosis Using Calcium Alginate and Collagen Bandages: A Randomized, Controlled Study. The use of the calcium alginate+collagen bandages in the treatment of ischemic ulcers in patients with systemic sclerosis proved more effective than saline solution regarding quality of life and pinch strength variables. S. R. Toffolo. [SAT0235] EULAR 2009. |
| Vitamin E gel reduces time of healing of digital ulcers in systemic sclerosis. The application of vitamin E gel reduces time of healing and has a faster resolution of pain, with a significant reduction of costs. Topical vitamin E may improve the management of digital ulcers in systemic sclerosis (SSc). Clin Exp Rheumatol. 2009 May-Jun. |
| Endothelin Receptor Antagonist (ERA) - Also see Bosentan, Tracleer |
| Also see Bosentan, Tracleer. |
| Hyperbaric Oxygen Therapy |
| Hyperbaric oxygen therapy (HBOT) . Foot wounds from diabetes, radiation ulcers, and other ischemic wounds have been manipulated and successfully treated with HBO. However, HBOT is not without side effects. Side effects include oxygen toxicity as well as barotrauma, a physical damage to body tissue caused by pressure differences inside and outside the body. Cincinnati Hyperbarics, 2009. |
| Hyperbaric oxygen therapy (HBOT) for wound healing and limb salvage: a systematic review. There is a moderate level of evidence that HBOT promotes healing of arterial ulcers, calciphylactic and refractory vasculitic ulcers, as well as refractory osteomyelitis. Goldman RJ. (PudMed) PM R. 2009 May;1(5):471-89. |
| Iloprost |
| A score of risk factors associated with ischemic digital ulcers (DUs) in patients affected by systemic sclerosis treated with iloprost. In this retrospective study, scleroderma patients with ischemic DUs are characterized by early disease onset, delay in beginning iloprost therapy, smoking habit, and presence of joint contraction. A score reflecting the sum of these factors may be useful to predict the risk of developing ischemic DUs. P. Caramaschi. (Springerlink) Clinical Rheumatology. March 20, 2009 (Also see: Smoking) |
| Digital ulcers and outcomes assessment in scleroderma.. Healing has been demonstrated with intravenous iloprost and two studies with bosentan have demonstrated reduction in the occurrence of new digital ulcers (DUs) over 4-6 months of treatment. (PubMed) Matucci-Cerinic M. Rheumatology (Oxford). 2008 Oct;47 Suppl 5:v46-7. (Also see: Bosentan) |
| Low versus High-dose Iloprost Therapy Over 21 Days in Patients with Secondary Raynaud's Phenomenon and Systemic Sclerosis: A Randomized, Open, Single-center Study. Low-dose iloprost was shown to be equally effective as high-dose iloprost in longterm treatment and was very effective in therapy of digital ulcers. A. Kawald. J Rheumatol. July 15 2008. (Also see: Scleroderma Treatments, Raynaud's,and Skin Fibrosis). |
| Infliximab, Remicade, Anti-TNF (Tumor necrosis factor-a antibody) |
| Clinical approach to cutaneous vasculitis. The new biologic therapies that act via cytokine blockade or lymphocyte depletion, such as the tumor necrosis factor-alpha inhibitor infliximab and the anti-B-cell antibody rituximab, respectively, are showing benefit in certain settings such as connective tissue disease and ANCA-associated vasculitis. Chen KR. (PubMed) Am J Clin Dermatol. 2008;9(2):71-92. |
| N-Acetylcysteine |
| The treatment with N-acetylcysteine (NAC) of Raynaud’s phenomenon and ischemic ulcers therapy in sclerodermic (SSc) patients: a prospective observational study of 50 patients. Long-term therapy with NAC, in patients with SSc, has a durable effectiveness on ischemic ulcers and Raynaud's phenomenon. Edoardo Rosato. Clinical Rheumatology. August 19, 2009 (Also see: Raynaud’s Treatments) |
| Quinapril: Warning, Do Not Use |
| Study warns against use of quinapril to treat digital ulcers in cutaneous sclerosis patients. The study concludes that based on these results, the routine use of ACE inhibition in treating upper-limb digital ulcers or other vascular manifestations in patients with systemic sclerosis is not advisable. Dermatology Times E-News. 01/03/08. (Also see: Quinapril for Scleroderma) |
| Prevention of vascular damage in scleroderma and autoimmune Raynaud's phenomenon: A multicenter, randomized, double-blind, placebo-controlled trial of the angiotensin-converting enzyme inhibitor quinapril. Administration of quinapril for up to 3 years had no demonstrable effects on the occurrence of upper limb digital ulcers or on other vascular manifestations of lcSSc in this patient population. PubMed. Arthritis Rheum. 2007 Oct 29;56(11):3837-3846. (Also see: Raynaud's) |
| Statins |
| Statins: Potentially Useful in Therapy of Systemic Sclerosis-related Raynaud's Phenomenon (RP) and Digital Ulcers (DU) . Our results showed that statins retarded vascular injury and improved patient function. The findings suggest that statins may aid in treating RP and DU in SSc patients. A. Abou-Raya. Journal of Rheumatology. August 15, 2008. (Also see: Raynaud's and Statins) |
| Stem Cells, Topical Application for Scleroderma Digital Ulcers |
| New Study Using Combination of Bioengineered Skin and Stem Cells Shows Promise in Treatment of Non-Healing Wounds. A new approach resulted in dramatic healing of these extremely difficult-to-heal wounds, with new skin growth that blended in nicely with the surrounding skin. (NewsWire) American Academy of Dermatology (AAD). 03/05/09. |
| Local implantation of autologous mononuclear cells (MNCs) from bone marrow and peripheral blood for treatment of ischaemic digits in patients with connective tissue diseases. Implantation of autologous MNCs from peripheral and bone marrow into the ischaemic digits was very effective in pain-relief and more clinical trials would be warranted to see whether this could be a new treatment modality for angiogenesis in connective tissue diseases as in Buerger's disease. PubMed. Rheumatology (Oxford). 2007 Feb 19. (Also see: Stem Cell Transplants) |
| Stem Cells Transplant |
| Therapeutic angiogenesis in patients with systemic sclerosis by autologous transplantation of bone-marrow-derived cells. Autologous transplantation of bone-marrow-derived cells was shown to be a novel and useful approach to intractable ulcers in systemic sclerosis. Yoshiaki Ishigatsubo. Modern Rheumatology. February 18, 2010 |
| Autologous stem cell transplantation improves microcirculation in systemic sclerosis. These results indicate that HSCT with high dose CYC regimen may foster vascular remodelling while CYC at lower doses and with a chronic regimen does not influence the microvasculature. Ann Rheum Dis. Published Online First: 28 February 2008. |
| Surgery |
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| Peripheral arterial- bypass grafts in the hand or foot in systemic sclerosis. Following successful vascular reconstruction on two adult patients, digital temperatures, pain and cold sensitivity and health-related quality of life improved significantly. No recurrence has been encountered after X and Y months of follow-up. Kwon ST. (PubMed) J Plast Reconstr Aesthet Surg. 2009 Jul;62(7):e216-21. |
| Ulnar artery vasculopathy in systemic sclerosis. It is suggested that angiographic screening and early surgical intervention such as revascularization should be considered in patients with systemic sclerosis who manifest a severe form of Raynaud’s phenomenon and/or digital ulceration and especially in patients with diffuse sclerosis. Jeong Ha Park. Rheumatology International. April 12, 2009. (Also see: Raynaud’s) |
| Wound healing after hand surgery in patients with systemic sclerosis-a retrospective analysis of 41 operations in 19 patients. In systemic sclerosis, surgery performed electively does not seem to have increased difficulty with wound healing. Even larger operations, such as wrist arthrodesis or wrist replacement, can be performed safely. PubMed. J Hand Surg [Br]. 2007 Feb 1. (Also see: Raynaud's Treatments) |
| Treprostinil (Remodulin) |
| Digital Ischemic Lesions in Scleroderma Treated With Oral Treprostinil Diethanolamine (DISTOL-1). This study will evaluate the effect of treprostinil diethanolamine (UT-15C) sustained release tablets(compared to placebo) on digital ulcers in patients with scleroderma. Principal Investigator: James Seibold, MD. Started May 2009. ClinicalTrials.gov. (Also see: Scleroderma Treatments and Clinical Trials) |
| Current treatment of systemic sclerosis. Part II. Vascular and antifibrotic treatment. Intravenous prostanoids (alprostadil, iloprost, epoprostenol, treprostinil) and endothelin receptor antagonists (bosentan, sitaxsentan, ambrisentan) show efficacy in treatment of pulmonary hypertension and distal ischemia. Sicińska J. (PubMed) Pol Merkur Lekarski. 2008 Aug;25(146):196-200. |
| Viagra (Sildenafil) |
| Effect of sildenafil on digital ulcers (DU) in systemic sclerosis (SSc): analysis from a single centre pilot study. This study indicates an effect of sildenafil on DU healing in patients with SSc and an improvement of Raynaud’s phenomenon and associated symptoms that should be validated in controlled studies. Claudia S Brueckner. Ann Rheum Dis. 11/08/09. (Also see: Raynaud's) |
| Fast and efficient healing of scleroderma-associated acral ulcers with sildenafil. This case demonstrates the efficacy of sildenafil in the treatment of scleroderma-associated refractory acral ulcers. PubMed (Hautarzt) 2007 Jul 22. (Also see: Pulmonary Hypertension) |
| Wound Care Product Index |
| Wound Care Product and Category Index The Wound Care Information Network by Dr. Allan Freedline |
| Raynaud's Prevention and Treatment |
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| Stories |
| Allen's Mom: Son has Scleroderma With his tightness of skin he has a very hard time bending, walking up the stairs and for the most part he cannot walk for more than a few minutes without his legs giving out... |
| Bren: CREST Scleroderma I had three ulcers on my hands from Raynaud's. I had Botox injections for them, and by the next day they were gone... |
| Christene: Limited Scleroderma I was diagnosed when I was just nineteen and at that time it was one of the scariest moments of my life... |
| Denise E: Diffuse Scleroderma I was first diagnosed with diffuse scleroderma in February 2002, but my symptoms began subtly in the summer of 2000... |
| D.M. Hoffe: Progressive Systemic Sclerosis (Scleroderma CREST) After an endoscopy it was discovered I had a Watermelon Stomach... |
| Dodo: Limited Systemic Scleroderma (Italy) The tips of my fingers turned cold, and then became cyanotic, always hurt and in the end they became ulcerated... |
| (Italiano) Dodo: Sclerodermia Sistemica Limitata (Italia) Ho iniziato ad avere alcune punte delle dita delle mani molto fredde, che in pochi giorni diventarono prima cianotiche, sempre piú doloranti e infine presentarono delle ulcere... |
| Doni: CREST Syndrome The doctors were always interested like, "Wow look at this," but since I had no insurance, they would not touch me... |
| Donna M: CREST Scleroderma It all started with an infection at the end of my index finger in December 1999. My finger became red, inflamed and sore to touch... |
| Dorothy: Scleroderma CREST For
this reason I convened a support group in South Africa to help encourage
many others with scleroderma... |
| Elizabeth G: Diffuse Scleroderma I was fired from my job since I cannot work as I used to... |
| Kathy GR: Scleroderma Patient The doctor who had been doing the nerve blocks had told me I had scleroderma, but never mentioned that I needed to see a rheumatologist... |
| Kym: Diffuse, CREST Scleroderma, Lupus and Fibromyalgia It all started with Raynaud's in my fingers and toes when I was about nineteen years old, in 1979... |
| Leslie R: Scleroderma, Vitiligo, Lupus, Anemia, Hypertension and Type 2 Diabetes He told me that I have scleroderma and explained what this disease is about. After suffering so long I finally got some answers... |
| Lynn F: Raynaud's and Scleroderma So on November 11th my finger was amputated just above the top knuckle. Unfortunately, an infection set in... |
| Mariposa: Progressive Systemic Sclerosis I have finger ulcers, also a second degree esophagitis, but I should say that about a year ago it started receding thanks to the doctors that follow my case... |
| Michelle T: Surviving Daughter of Systemic Sclerosis Patient In memory of my mother, who was my best friend, my strength, my drive, and my compassion, I am compelled every day of my life to educate others of this disease... |
| Myrianisa: Daughter of a Severe Scleroderma Patient My mother was diagnosed with scleroderma six years ago. At the same time, she was also diagnosed with lupus, Raynaud's, MCTD, pulmonary fibrosis and fibromyalgia... |
| Nathalie: Lupus/Scleroderma I arrived at the hospital with two black fingers. They had gangrene and I was very worried about having an amputation... |
| Rose M: CREST Syndrome I was finally correctly diagnosed with CREST after two years of thinking I was going crazy... |
| Rosemary F: Surviving Daughter of Diffuse Scleroderma Patient She tried to explain it, but it was hard for me to comprehend the disease's symptoms. Mom said that it was the same thing that her oldest sister died from... |
| Rosie: Limited Systemic Sclerosis (Australia) Some of my symptoms may not be due to limited scleroderma, however most of these symptoms have appeared since my diagnosis... |
| Sbirulino: Limited Systemic Sclerosis, First Stage Biliary Cirrhosis (Italy) They diagnosed Raynaud's Syndrome, until there was amputation of the first and second phalanges, which caused total invalidism... |
| (Italiano) Sbirulino: Sclerosi Sistemica variante Limitata, Cirrosi Biliare Primitiva (Italia) Mi avevano diagnosticato la sindrome di Reynaud, fino all'autoamputazione delle Ie e IIe falangi arrivando a portarmi ad una invalidità totale del 100%... |
| Sheila: CREST with Limited Scleroderma I felt really scared, confused, and dehumanized in the process of my diagnosis... |
| Sibel: Scleroderma and Raynaud's (Turkey) Changes in my skin were making me look different in the mirror... |
| Sue D: Diffuse Scleroderma Pain developed in my hands, then I noticed pain in my knees, then my shoulders, down my back, elbows, hips, feet... |
| Star S: Morphea and Systemic Scleroderma I was diagnosed with morphea at age seven. Now at age thirty-three, I have recently developed systemic scleroderma with gastrointestinal manifestations, Sjogren's syndrome, inflammatory arthritis, malabsorption... |
| Susie: CREST Syndrome I have had CREST syndrome for the past eight years. My specialist is Dr. Frederick Wigley, from Johns Hopkins... |
| Susie L: Raynaud's (and Scleroderma, too?) I have been told that I "probably" have scleroderma in the early stages by one doctor, that it is unlikely by another, and that I almost certainly do have it by yet another... |
| Tata P: Diffuse Scleroderma I am thirty-two years old, and I have been suffering this illness since I was nine... |
| (Español/Spanish) Tata P: Esclerodermia Difusa Hola, tengo 32 años, y padezco esta enfermedad desde los 9... |
| Teresa: Scleroderma I was just diagnosed a few hours ago. Tears are streaming down my face... |
| Yolima: Diffuse Scleroderma I was misdiagnosed for more than a year with so many diseases and given all types of medication for different problems except for the real disease... |
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