Management of Raynaud Phenomenon and Digital Ulcers in Scleroderma

Abstract

Raynaud phenomenon (RP) and associated digital ischemia can be among the most vexing clinical problems for patients with systemic sclerosis (scleroderma). Understanding the treatment approach to RP and associated ischemia and how to prevent digital ulcers is important for clinicians caring for these patients. This article reviews the management of RP and digital ischemic ulcers. The magnitude of the problem and pathophysiology of RP are first discussed, with an emphasis on recent advances in understanding of the disease process. Options for the practical pharmacologic and nonpharmacologic interventions for RP and digital ischemic ulcers are detailed.

Keywords: Calcium channel blocker; Digital ischemia; Digital ulcer; Prostacyclin; Raynaud phenomenon; Scleroderma; Thermoregulatory vessels.