Research on Digital Ulcers in Systemic Sclerosis (SSc, Scleroderma)

Author: Shelley Ensz. Scleroderma is highly variable. See Types of Scleroderma. Read Disclaimer


Systemic scleroderma and Raynaud's can cause painful ulcers on the fingers or toes, which are known as digital ulcers. (Also see What is Scleroderma?, Types of Scleroderma, Digital Ulcers, and Raynaud's)

Photo of Finger UlcerMost 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.

Elucidating the burden of recurrent and chronic digital ulcers (DU) in systemic sclerosis (SSc): long-term results from the DUO Registry. SSc-associated DUs based on the occurrence of DUs over time may help to identify patients in the clinic with a heavier DU burden who could benefit from more complex management to improve their functioning and quality of life. Ann Rheum Dis, 11/26/2015.

Dysfunctional arteriovenous anastomoses (AVAs) in hands of systemic sclerosis (SSc) patients with digital ulcers (DU). In SSc patients with DU there is a dysfunction of the AVAs of the finger pulp and AVA dysfunction may be a part of autonomic dysfunction in SSc. PubMed, Clin Exp Rheumatol, 05/21/2014. (Also see Digital Ulcers)

The association of antiphospholipid antibodies (APLA) with cardiopulmonary manifestations of systemic sclerosis. APLA is associated with pulmonary arterial hypertension (PH), interstitial lung disease, Raynaud's phenomenon and digital ulcers, so endothelial abnormalities and small vessel thrombosis may be important in the pathogenesis of these disease features. PubMed, Clin Exp Rheumatol, 02/24/2014. (Also see Antiphospholipid Syndrome, Causes of Pulmonary Hypertension, and Raynaud's)

Increased intrarenal arterial stiffness may predict the occurrence of new digital ulcers (DU) in systemic sclerosis. Doppler indices could be used in association with the capillaroscopic and clinical findings or serological tests for the identification of patients at high risk of developing DUs. PubMed, Arthritis Care Res (Hoboken), 02/10/2014. (Also see Digital Ulcers)

High serum sCD163/sTWEAK ratio is associated with lower risk of digital ulcers but more severe skin disease in patients with systemic sclerosis (SSc). Further studies are required to reveal whether targeting of the CD163-TWEAK pathway might be a potential strategy for treating vascular disease and/or skin fibrosis in SSc. Arthritis Research & Therapy, 06/24/2013, 15:R69.

Pills by Janet Paulmenn, ISN ArtistMacitentan is also known as Opsumit by Actelion. It is a dual endothelin receptor antagonist that was submitted for FDA approval for use in pulmonary hypertension in December 2012.Clinical Trial: Macitentan for the Treatment of Digital Ulcers in Systemic Sclerosis Patients (DUAL-2). The primary objective is to demonstrate the effect of macitentan on the reduction of the number of new digital ulcers in patients with systemic sclerosis and ongoing digital ulcers (DU). 12/18/12. (Also see Scleroderma Clinical Trials)

Stress dramatically slows wound healing!

The Impact of Psychological Stress on Wound Healing: Methods and Mechanisms. Converging and replicated evidence from experimental and clinical models of wound healing indicate that psychological stress leads to clinically relevant delays in wound healing. NIH, Immunol Allergy Clin North Am, [2011]. (Also see Emotional Adjustment)

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