title: Severe refractory fingertip ulcerations in a patient with scleroderma: successful treatment with sildenafil.
abstract: 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.
authors.affiliation: Section on Rheumatology and Immunology, Department of Internal Medicine, Wake Forest University Baptist Medical Center, Winston Salem, North Carolina, USA. leecolglazier@hotmail.com
authors.forename: Christopher Lee
authors.initials: CL
authors.lastname: Colglazier
authors.forename: Paul G
authors.initials: PG
authors.lastname: Sutej
authors.forename: Kenneth S
authors.initials: KS
authors.lastname: O'Rourke
mesh_terms: 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*
chemical_list: D010879:Piperazines; D011687:Purines; D013450:Sulfones; D014665:Vasodilator Agents; D000068677:Sildenafil Citrate