Management of Raynaud Phenomenon and Digital Ulcers in Scleroderma

Laura Cappelli; Fredrick M Wigley

doi:10.1016/j.rdc.2015.04.005

Management of Raynaud Phenomenon and Digital Ulcers in Scleroderma

Rheum Dis Clin North Am. 2015 Aug;41(3):419-38. doi: 10.1016/j.rdc.2015.04.005. Epub 2015 May 23.

Authors

Laura Cappelli¹, Fredrick M Wigley²

Affiliations

¹ Division of Rheumatology, Johns Hopkins University School of Medicine, 5200 Eastern Avenue, Suite 4100, Mason F. Lord Building, Center Tower, Baltimore, MD 21224, USA.
² Division of Rheumatology, Johns Hopkins University School of Medicine, 5200 Eastern Avenue, Suite 4100, Mason F. Lord Building, Center Tower, Baltimore, MD 21224, USA. Electronic address: fwig@jhmi.edu.

PMID: 26210127
DOI: 10.1016/j.rdc.2015.04.005

Abstract

Raynaud phenomenon (RP) and associated digital ischemia can be among the most vexing clinical problems for patients with systemic sclerosis (scleroderma). Understanding the treatment approach to RP and associated ischemia and how to prevent digital ulcers is important for clinicians caring for these patients. This article reviews the management of RP and digital ischemic ulcers. The magnitude of the problem and pathophysiology of RP are first discussed, with an emphasis on recent advances in understanding of the disease process. Options for the practical pharmacologic and nonpharmacologic interventions for RP and digital ischemic ulcers are detailed.

Keywords: Calcium channel blocker; Digital ischemia; Digital ulcer; Prostacyclin; Raynaud phenomenon; Scleroderma; Thermoregulatory vessels.

Publication types

Case Reports
Review

MeSH terms

Adult
Female
Fingers* / blood supply
Humans
Raynaud Disease / etiology
Raynaud Disease / therapy*
Scleroderma, Systemic / complications*
Ulcer / drug therapy
Ulcer / etiology
Ulcer / therapy*