Healing Of Digital Ulcers Research Articles

Cartilage collagens: strategies for the study of their organisation and expression in the extracellular matrix.

<h3>Objective</h3> In this pilot study, the effect of sildenafil on digital ulcer (DU) healing and related clinical symptoms was analysed. <h3>Methods</h3> A total of 19 patients with systemic sclerosis (SSc) were treated with maximally tolerated sildenafil doses up to 6 months. Primary outcome was the healing of DUs. Changes in other clinical symptoms were also evaluated. <h3>Results</h3> In all, 49 DUs were present at baseline; this decreased to 17 ulcers (p&lt;0.001) at the end of sildenafil treatment. Furthermore, the visual analogue scale (VAS) score for Raynaud9s phenomenon (RP), pain and activity improved (p=0.003, p=0.002 and p=0.05, respectively). A total of 9 patients developed 12 new DUs during sildenafil treatment. <h3>Conclusions</h3> This study indicates an effect of sildenafil on DU healing in patients with SSc and an improvement of RP and associated symptoms that should be validated in controlled studies.

Therapeutic efficacy of ketanserin, a selective antagonist of the serotonin (5-HT2) receptors, in primary and secondary Raynaud's phenomenon.

Fourteen ambulatory and hospitalized patients with primary and secondary Raynaud's phenomenon have been examined before and after a thirty-one-day therapeutic trial. The treatment was conducted in two cycles. The first one lasted ten days, during which placebo was administered. The second cycle lasted three weeks, during which ketanserin, a selective antagonist of 5-hydroxytryptamine (5-HT2) receptors, was administered. The therapeutic effect consisted of the complete healing of digital ulcers in 4 of 5 patients and a considerable decrease in the number, length, and severity of daily attacks. To evaluate the digital blood flow, each patient was submitted to a medical dynamic telethermographic test. This, after the cooling test, demonstrated an average decrease of twenty minutes in the time necessary to reestablish basal thermal conditions (T') at the end of an adequate period of therapy using optimal doses of the drug. The authors affirm that orally administered ketanserin has a beneficial effect and can be well tolerated in subjects with Raynaud's phenomenon.

Nifedipine as a therapeutic modality for Raynaud's phenomenon.

Eight patients with Raynaud's phenomenon were entered into a double-blind crossover study of nifedipine versus placebo, with 7 patients undergoing finger plethysmography before and after sublingual nifedipine administration. While receiving nifedipine, all patients reported decreased frequency and severity of attacks, and 4 of 5 had digital ulcer healing. Total finger blood flow increased 5 of 6 patients after treatment with sublingual nifedipine. This preliminary study indicates that nifedipine may be a useful agent for treatment of digital vasospasm.