[Digital ulcers in a cohort of 333 scleroderma patients].
Digital ulcers (DU) at the hands are one of the more frequent and severe complications in systemic sclerosis. Data on their prevalence and distribution in the different subsets of disease are variable in the literature. We studied the frequency of DU in a cohort of 333 scleroderma patients followed in the last 10 years in our Unit. DU have been recorded in 133 patients (39,9%), more frequently in males, in patients with cutaneous diffuse form of disease and in patients with anti-Scl70 ANA specificity. Complications of DU have been observed in 12,3% of cases. Surgery of the hands has been required in 8,7% of patients. The more effective treatment of DU are i.v. prostanoids, performed usually in day hospital, with high costs for the National Health Service. Recently the efficacy of bosentan, an oral receptor antagonist of endothelin, has been demonstrated, thus opening new perspectives in the treatment of DU in systemic sclerosis.
Tiso
F
F
Cattedra e U.O.C. di Reumatologia, Dipartimento di Medicina Clinica e Sperimentale, Policlinico Universitario, Padova, Italia.
Favaro
M
M
Ciprian
L
L
Cardarelli
S
S
Rizzo
M
M
Tonello
M
M
Ruffatti
A
A
Cozzi
F
F
D000328:Adult; D000368:Aged; D001323:Autoantibodies / Q000276:immunology; D000077300:Bosentan; D002503:Centromere / Q000276:immunology; D015331:Cohort Studies; D004264:DNA Topoisomerases, Type I; D065128:Endothelin Receptor Antagonists; D005260:Female; D005385:Fingers / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009687:Nuclear Proteins / Q000276:immunology; D015995:Prevalence; D011453:Prostaglandins / Q000627:therapeutic use; D045743:Scleroderma, Diffuse / Q000150:complications* / Q000276:immunology; D012883:Skin Ulcer / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology* / Q000601:surgery; D013449:Sulfonamides / Q000627:therapeutic use
D001323:Autoantibodies; D065128:Endothelin Receptor Antagonists; D009687:Nuclear Proteins; D011453:Prostaglandins; C048100:Scl 70 antigen, human; D013449:Sulfonamides; D004264:DNA Topoisomerases, Type I; D000077300:Bosentan