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Review
. 2022 Dec;36(4):101813.
doi: 10.1016/j.berh.2022.101813. Epub 2023 Jan 5.

Novel therapies and innovation for systemic sclerosis skin ulceration

Affiliations
Review

Novel therapies and innovation for systemic sclerosis skin ulceration

Tracy M Frech et al. Best Pract Res Clin Rheumatol. 2022 Dec.

Abstract

Skin ulceration is an important cause of morbidity in systemic sclerosis and can occur at anytime during disease progression. Incident disease cohorts are important for understanding whether skin ulceration represents active vasculopathy versus resultant damage. Biomarkers for skin ulcer pathogenesis, both serum and imaging, are under investigation to elucidate the functional consequences of the structural abnormalities. Novel therapeutics for the treatment of vasculopathy benefit from reliable biomarkers able to predict the disease evolution remains an important unmet need. Nonetheless, a diagnostic approach that captures early skin ulceration and treatments that restore vascular and immune homeostasis is critical for effective systemic sclerosis (SSc) vasculopathy management.

Keywords: Capillaroscopy; Skin ulcer; Systemic sclerosis; Vasculopathy.

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Conflict of interest statement

Declaration of competing interest None declared.

Figures

Fig. 1.
Fig. 1.
SSc skin ulceration caused by (A) trauma, (B) calcinosis, and (C) recurrent ischemia.
Fig. 2.
Fig. 2.
Digital ulcer quantification for healing rate calculation.
Fig. 3.
Fig. 3.
Calcinosis debulking during ulcer wound care.
Fig. 4.
Fig. 4.
Excerpt of a video of immune cell adhering to the vascular endothelium in a SSc patient via reflectance confocal videomicroscopy. Data taken at Vanderbilt Dermatology Translational Research Clinic.

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