open access

Vol 8, No 1 (2022)
Case report
Published online: 2022-06-17
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Prostaglandin E1 — salvage therapy in the treatment of difficult-to-heal ulcers in systemic sclerosis

Joanna Musiał1, Jolanta Bucka
DOI: 10.5603/RF.2022.0005
·
Rheumatology Forum 2022;8(1):31-36.
Affiliations
  1. Department of Rheumatology, Małopolska Centre for Rheumatology Immunology and Rehabilitation, Józef Dietl Hospital in Kraków, al. Focha 33, 30-119 Kraków, Poland

open access

Vol 8, No 1 (2022)
Case report
Published online: 2022-06-17

Abstract

Involvement of blood vessels in the form of Raynaud’s phenomenon and microcirculatory dysfunction as well as accompanying skin lesions of the fingers in patients with systemic sclerosis lead to easy skin damage and difficult-to-heal ulcers. Patient education regarding, among other things, the avoidance of injuries, exposure to cold or smoking and pharmacological treatment are becoming important. The choice of drugs listed in current recommendations depends on the clinical manifestation, i.e. the presence and severity of Raynaud’s phenomenon, the treatment or prevention of ulceration and the response to previous treatment. The paper presents a case of a 79-year-old woman with advanced necrotic lesions of the fingers in the course of systemic sclerosis diagnosed late in life. Due to the advancement of the lesions and the lack of improvement after first-line oral medications, the patient required intravenous prostaglandin. Six months of effective therapy and additional surgical treatment led to complete healing and inhibition of new ulcer formation. Intravenous prostaglandin is an effective alternative for the treatment of difficult-toheal ulcers in the course of systemic sclerosis while preventing the formation of new lesions.

Abstract

Involvement of blood vessels in the form of Raynaud’s phenomenon and microcirculatory dysfunction as well as accompanying skin lesions of the fingers in patients with systemic sclerosis lead to easy skin damage and difficult-to-heal ulcers. Patient education regarding, among other things, the avoidance of injuries, exposure to cold or smoking and pharmacological treatment are becoming important. The choice of drugs listed in current recommendations depends on the clinical manifestation, i.e. the presence and severity of Raynaud’s phenomenon, the treatment or prevention of ulceration and the response to previous treatment. The paper presents a case of a 79-year-old woman with advanced necrotic lesions of the fingers in the course of systemic sclerosis diagnosed late in life. Due to the advancement of the lesions and the lack of improvement after first-line oral medications, the patient required intravenous prostaglandin. Six months of effective therapy and additional surgical treatment led to complete healing and inhibition of new ulcer formation. Intravenous prostaglandin is an effective alternative for the treatment of difficult-toheal ulcers in the course of systemic sclerosis while preventing the formation of new lesions.

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Keywords

Raynaud’s phenomenon; ulcers; systemic sclerosis; prostaglandin

About this article
Title

Prostaglandin E1 — salvage therapy in the treatment of difficult-to-heal ulcers in systemic sclerosis

Journal

Rheumatology Forum

Issue

Vol 8, No 1 (2022)

Article type

Case report

Pages

31-36

Published online

2022-06-17

Page views

1933

Article views/downloads

64

DOI

10.5603/RF.2022.0005

Bibliographic record

Rheumatology Forum 2022;8(1):31-36.

Keywords

Raynaud’s phenomenon
ulcers
systemic sclerosis
prostaglandin

Authors

Joanna Musiał
Jolanta Bucka

References (11)
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  8. Kowal-Bielecka O, Kowal K. Twardzina układowa. In: Zimmermann-Górska I. ed. Terapia w chorobach reumatycznych. Vol. I. PZWL Wydawnictwo Lekarskie, Warszawa 2018: 323–324.
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