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Digital Ischemic Loss in Systemic Sclerosis

By Umaima Marvi and Lorinda Chung


Digital ischemic loss is a cause of significant morbidity in patients with systemic sclerosis (SSc). Microvascular disease with intimal proliferation and luminal narrowing of small digital arteries, as well as macrovascular disease with narrowing or occlusion of larger digital arteries, contribute to the perfusion defects involved in digital ischemic loss. Immediate clinical evaluation and treatment are mandatory at the onset of critical digital ischemia to prevent digital loss. Hospitalization for medical therapies including intravenous prostacyclin therapy should be considered for all SSc patients who present with critical digital ischemia. Surgical interventions are typically reserved for patients who fail medical therapies and for those with late stage, necrotic tissue. This paper summarizes the current knowledge regarding the risk factors, pathogenesis, evaluation, and treatment of digital ischemic loss in SSc

Topics: Review Article
Publisher: Hindawi Publishing Corporation
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Provided by: PubMed Central

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  1. (1994). A .L .H e r r i c k ,M .H e a n e y ,S .H o l l i s ,a n dM .I .V .J a y s o n ,“ A n t i -cardiolipin, anti-centromere and anti-Scl-70 antibodies in patients with systemic sclerosis and severe digital ischaemia,” Annals of the Rheumatic Diseases,
  2. (1994). A .L .H e r r i c k ,P .K .O o g a r a h ,A .J .F r e e m o n t ,R .M a r c u s o n
  3. (2003). A systematic review of the outcomes of digital sympathectomy for treatment of chronic digital ischemia,”
  4. (2001). Amputations in systemic sclerosis: the influence of disease subtype, anticentromere antibody and smoking status,”
  5. (2002). andL.Casciola-Rosen,“RecognitionofgranzymeB-generated autoantigen fragments in scleroderma patients with ischemic digitalloss,”ArthritisandRheumatism,vol.46,no.7,pp.1873– 1884,
  6. (1992). Anti-centromere antibody as a predictor of digital ischemic loss in patients with systemic sclerosis,”
  7. (2006). Arteriographic evaluation of vascular changes of the extremities in patients with systemic sclerosis,”
  8. (2009). Capillaroscopic skin ulcer risk index: a new prognostic tool for digital skin ulcer development in systemic sclerosis patients,”
  9. (2008). Chifflo t ,B .F a u t r e l ,C .S o r d e t ,E .C h a t e l u s ,a n dJ .S i b i l i a , “Incidence and prevalence of systemic sclerosis: a systematic literature review,”
  10. (2002). Cigarette smoking as a significant risk factor for digital vascular disease in patients with systemic sclerosis,”
  11. (2008). Clinical burden of digital vasculopathy in limited and diffuse cutaneous systemic sclerosis,”
  12. (2000). D.B.Badesch,V.F.Tapson,M.D.McGoonetal.,“Continuous intravenous epoprostenol for pulmonary hypertension due to thesclerodermaspectrumofdisease:arandomized,controlled trial,”
  13. (2008). Diagnosis and management of scleroderma peripheral vascular disease,” Rheumatic Disease
  14. (2000). Iloprost and cisaprost for Raynaud’s phenomenon in progressive systemic sclerosis,”
  15. (2009). Independent association of anti-β2-glycoprotein I antibodies with macrovascular disease and mortality in scleroderma patients,”
  16. (1994). Intravenous iloprost infusion in patients with Raynaud phenomenon secondary to systemic sclerosis: a multicenter, placebocontrolled, double-blind study,”
  17. (1998). L.Stafford,H.Englert,J.Gover,andJ.Bertouch,“Distribution of macrovascular disease in scleroderma,”
  18. (2009). Longterm results of periarterial sympathectomy,”
  19. (2003). Management of Raynaud’s phenomenon and digital ischemic lesions in scleroderma,”
  20. (2006). Mechanisms and consequences of fibrosis in systemic sclerosis,”
  21. (2009). Peripheral arterial- bypass grafts in the hand or foot in systemic sclerosis,”
  22. (2005). Surgery of the hand in patients with systemic sclerosis: outcomes and considerations,”
  23. (2009). Surgical result of critical limb ischemia due to tibialarterialocclusioninpatientswithsystemicscleroderma,”
  24. (2002). Ulnar artery involvement in systemic sclerosisInternational
  25. (2009). Ulnar artery vasculopathy in systemic sclerosis,”
  26. (1992). W i g l e y ,J .R .S e i b o l d