Severe refractory fingertip ulcerations in a patient with scleroderma: successful treatment with sildenafil.
Systemic sclerosis (scleroderma) is a multisystem fibrotic disease that commonly manifests with severe Raynaud's phenomenon and slow-healing cutaneous ulcerations. Reduced nitric oxide levels have been proposed to play a role in the pathogenesis of vascular disease in scleroderma, and therefore sildenafil (which increases nitric oxide levels) is an attractive therapeutic prospect. We describe a patient with limited cutaneous systemic sclerosis who presented with severe nonhealing finger ulcerations despite conventional management, who showed marked improvement with oral sildenafil.
Colglazier
Christopher Lee
CL
Section on Rheumatology and Immunology, Department of Internal Medicine, Wake Forest University Baptist Medical Center, Winston Salem, North Carolina, USA. leecolglazier@hotmail.com
Sutej
Paul G
PG
O'Rourke
Kenneth S
KS
D000284:Administration, Oral; D000328:Adult; D005385:Fingers / Q000473:pathology; D006801:Humans; D008297:Male; D010879:Piperazines / Q000008:administration & dosage* / Q000627:therapeutic use*; D011687:Purines; D012595:Scleroderma, Systemic / Q000150:complications*; D000068677:Sildenafil Citrate; D012883:Skin Ulcer / Q000188:drug therapy* / Q000209:etiology* / Q000473:pathology; D013450:Sulfones; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use*
D010879:Piperazines; D011687:Purines; D013450:Sulfones; D014665:Vasodilator Agents; D000068677:Sildenafil Citrate