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)
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.
The incidence rate of pulmonary arterial hypertension (PAH) and scleroderma renal crisis (SRC) in systemic sclerosis patients with digital ulcers on endothelin antagonist receptors (ERAs) and phosphodiesterase-5 inhibitors (PDE5i). Treatment with ERAs and/or PDE5i appeared to delay the occurrence of SRC. PubMed, Rheumatology (Oxford), 2020 Aug 26;keaa401. (Also see Pulmonary Hypertension and Kidney (Renal) Involvement)
Study of “Pre-Ulcer ” Stage May Inform Treatment of Digital Ulcers in Scleroderma. These findings can help develop strategies to prevent digital ulcers, such as avoiding severe cold, hand hygiene, and avoiding mechanical injury. Scleroderma News, 02/21/2020.
Should all digital ulcers (DUs) be included in future clinical trials of systemic sclerosis (SSc)–related digital vasculopathy? We would encourage the expert SSc community to reconsider the rationale for including only fingertip DUs in future SSc clinical trials, and suggest an agenda for future research. PubMed, Med Hypotheses, 2018 Jul;116:101-104.
In systemic sclerosis skin perfusion of hands is reduced and may predict the occurrence of new digital ulcers (DUs). Laser Doppler perfusion imaging indices could be used in association to the capillaroscopic and clinical findings or serological tests in the identification of patients at high risk of developing DUs. PubMed, Microvasc Res, 2017 Mar;110:1-4.
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. (Also see Antiphospholipid Syndrome, Causes of Pulmonary Hypertension, and Raynaud's)
Stress-related changes to immune cells in the skin prior to wounding may impair subsequent healing. These studies show the first preliminary evidence that the number and activation of immune cells in the skin prior to wounding are affected by stress and can impact healing. PubMed, Brain Behav Immun. (Also see Emotional Adjustment)
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