Document Detail

Digital ulcers: overt vascular disease in systemic sclerosis.
MedLine Citation:
PMID:  19487218     Owner:  NLM     Status:  MEDLINE    
RP is an almost universal manifestation of SSc, with 95% of all patients being affected, and resulting in digital ulcers (DUs) in approximately 30% of the patients each year. DUs are a major clinical problem, being associated with substantial morbidity (reduced quality of life, pain, disability and disfigurement) that can escalate to gangrene and amputation. Ideally, the treatment of DUs would improve tissue integrity and viability, promote ulcer healing and reduce the formation of new ulcers. Treatments that have shown potential include calcium channel blockers, prostacyclin analogues and endothelin receptor antagonists. However, until recently, management was based on empirical experience. The recent approval (in Europe) of the dual endothelin receptor antagonist, bosentan, to reduce the number of new DUs in patients with SSc and ongoing DU disease, means that there is now an approved therapy--and new hope--for the treatment of DUs in these severely afflicted patients.
V Steen; C P Denton; J E Pope; M Matucci-Cerinic
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Rheumatology (Oxford, England)     Volume:  48 Suppl 3     ISSN:  1462-0332     ISO Abbreviation:  Rheumatology (Oxford)     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-06-02     Completed Date:  2009-07-06     Revised Date:  2013-06-18    
Medline Journal Info:
Nlm Unique ID:  100883501     Medline TA:  Rheumatology (Oxford)     Country:  England    
Other Details:
Languages:  eng     Pagination:  iii19-24     Citation Subset:  AIM; IM    
Department of Medicine, Georgetown University Medical Center, Washington, DC 20007, USA.
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MeSH Terms
Antihypertensive Agents / therapeutic use
Databases, Factual
Endothelium, Vascular / physiopathology
Fingers / blood supply
Hand Dermatoses / etiology*,  physiopathology
Raynaud Disease / etiology*,  physiopathology
Scleroderma, Systemic / complications*,  physiopathology,  therapy
Skin Ulcer / etiology*,  physiopathology
Sulfonamides / therapeutic use
Reg. No./Substance:
0/Antihypertensive Agents; 0/Sulfonamides; Q326023R30/bosentan

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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