Efficacy of bosentan in the prevention of new digital ulcers in a patient with systemic sclerosis (case report)

Authors: S. Skácelová 1;  R. Bečvář 1;  J. Štork 2
Authors‘ workplace: Revmatologický ústav Praha 1;  Dermatovenerologická klinika 1. LF UK, Praha 2
Published in: Čes. Revmatol., 20, 2012, No. 2, p. 74-81.
Category: Case Report


Digital ulcers (DU) and Raynaud’s phenomenon are clinical manifestations of digital vasculopathy in patients with systemic sclerosis. They occur in about one third of patients. This is a very painful condition associated with serious complications such as infection or gangrene. Digital ulcers significantly limit the functional ability of the hand and reduce the patients’ quality of life. Approximately 1-2% of patients with DU require amputation of the distal phalanx. Systemic pharmacotherapy of trophic digital ulcers is based on the use of calcium channel blockers, intravenous prostanoids, analgesics, antiplatelet agents, and antibiotics. Bosentan, a dual endothelin receptor antagonist, is the new hope for patients with DU. Bosentan significantly reduces the formation of new ulcers. It is suitable for patients who suffer from multiple recurrent digital ulcers. In this article the authors present an overview of literature data on the epidemiology, pathophysiology and treatment of digital vasculopathy in systemic sclerosis. The issue of treatment of recurrent digital ulcers in systemic sclerosis is documented by a case report.

Key words:
systemic sclerosis, digital ulcers, bosentan


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