Digital Ulcers

Physicians should use more aggressive therapy for patients with systemic sclerosis who are at high risk for digital ulcers, according to researchers who identified a…

Digital ulcers happen in up to 60% of Scleroderma patients. They are ischaemic in nature, reflecting endothelial dysfunction and microvascular insufficiency. As such, they are harbingers of worse complications to come in SSc, like pulmonary hypertension and heart failure. More immediately, ulcers beget more ulcers.
Predicting who will develop ulcers may help to forestall such complications. Risk factors include telangiectasias and diffuse skin sclerosis.
As for treatment, vasodilators like calcium channel blockers and ACE inhibitors won’t cut it. You need to resort to the big guns used in treating pulmonary hypertension like PDE5 inhibitors, prostacyclins and endothelin receptor antagonists.