A Case of Digital Ulcer in Systemic Sclerosis, Treated with Oral Sildenafil (Phosphodiesterase-5 Inhibitor, Viagra®)

Abstract

Systemic sclerosis is a connective tissue disease characterized by cutaneous and visceral fibrosis, as well as vascular disease involving arterioles, small and medium arteries of the peripheral circulation. Digital ulcers, defined as necrotic lesions that occur either at distal aspects of digits or over bony prominence, occur in up to 50% of patients with limited or diffuse systemic sclerosis. These lesions are exquisitely painful, heal slowly, and lead to substantial functional disability. We describe a 59-year-old woman with systemic sclerosis, suffering from a painful, non-healing digital ulcer despite conventional therapies, who demonstrated dramatic improvement with oral sildenafil treatment.