title: Management of Raynaud's phenomenon and digital ulcers in systemic sclerosis.
abstract: Raynaud's phenomenon (RP) and digital ulcers (DU) are the clinical manifestations of vasculopathy in systemic sclerosis. Both interfere with hand function and hold the possibility of severe complications, thus adversely influencing patients' quality of life. Managing RP and DU is often a challenge for the treating physician, who has to establish a treatment plan based upon knowledge of the current therapeutic options. The first step is to differentiate primary from secondary RP, where combining history and physical examination with diagnostic modalities, such as nailfold capillaroscopy, aids in reaching the correct diagnosis. Next a wide range of treatment options is offered nowadays, starting from first-line agents, as calcium channel blockers, to the more targeted-ones, like endothelin receptor antagonists. Research and clinical experience with each agent are reviewed in the text, as well as the combinations that more recently gain field in the treatment of DU.
authors.affiliation: Department of Internal Medicine, Rheumatology Clinic, Medical School, University of Ioannina, 45110 Ioannina, Greece.
authors.forename: Vasileios
authors.initials: V
authors.lastname: Botzoris
authors.forename: Alexandros A
authors.initials: AA
authors.lastname: Drosos
mesh_terms: D000077300:Bosentan; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D065128:Endothelin Receptor Antagonists; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D005385:Fingers; D006801:Humans; D058986:Phosphodiesterase 5 Inhibitors / Q000627:therapeutic use; D044062:Prostaglandins I / Q000627:therapeutic use; D011928:Raynaud Disease / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D012595:Scleroderma, Systemic / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D012883:Skin Ulcer / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D013449:Sulfonamides / Q000627:therapeutic use; D014665:Vasodilator Agents / Q000627:therapeutic use
chemical_list: D002121:Calcium Channel Blockers; D002317:Cardiovascular Agents; D065128:Endothelin Receptor Antagonists; D004791:Enzyme Inhibitors; D058986:Phosphodiesterase 5 Inhibitors; D044062:Prostaglandins I; D013449:Sulfonamides; D014665:Vasodilator Agents; D000077300:Bosentan