Management of digital ulcers in systemic sclerosis

Systemic sclerosis (SSc) is a rare disease characterized by autoimmune pathogenesis, alterations to the vascular system, and fibrosis of the skin and internal organs. Digital ulcers (DUs) are common in SSc patients, and represent a major burden for the patients. The management of DUs in systemic sclerosis is difficult, because it needs a multimodal therapeutic approach, as local treatment alone is usually insufficient and also systemic treatment with vasoactive drugs and modification of the lifestyle are usually required for healing of the wounds. In this review, we describe the optimal management of DUs according to recent literature and our clinical practice for systemic and local treatment of chronic digital wounds in SSc patients.