Raynauds phenomenon and digital ischemia: A practical approach to risk stratification, diagnosis and management

Research output: Contribution to journalArticle

Abstract

Digital ischemia is a painful and often disfiguring event. Such an ischemic event often leads to tissue loss and can significantly affect the patients quality of life. Digital ischemia can be secondary to a vasculopathy, vasculitis, embolic disease, trauma or extrinsic vascular compression. It is an especially serious complication in patients with scleroderma. Risk stratification of patients with scleroderma at risk for digital ischemia is now possible with clinical assessment and autoantibody profiles. Because there are a variety of conditions that lead to digital ischemia, it is important to understand the pathophysiology underlying each ischemic presentation in order to target therapy appropriately. Significant progress has been made in the last 20 years in defining the pathophysiological processes leading to digital ischemia in rheumatic diseases. In this article we review the risk stratification, diagnosis and management of patients with digital ischemia and provide a practical approach to therapy, particularly in scleroderma.

Original languageEnglish (US)
Pages (from-to)355-370
Number of pages16
JournalInternational Journal of Clinical Rheumatology
Volume5
Issue number3
DOIs
StatePublished - Jun 2010

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Raynaud Disease
Ischemia
Vasculitis
Rheumatic Diseases
Autoantibodies
Blood Vessels
Quality of Life
Wounds and Injuries
Therapeutics

Keywords

  • Digital ischemia
  • Digital ulcers
  • Raynaud's phenomenon
  • Scleroderma

ASJC Scopus subject areas

  • Rheumatology

Cite this

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abstract = "Digital ischemia is a painful and often disfiguring event. Such an ischemic event often leads to tissue loss and can significantly affect the patients quality of life. Digital ischemia can be secondary to a vasculopathy, vasculitis, embolic disease, trauma or extrinsic vascular compression. It is an especially serious complication in patients with scleroderma. Risk stratification of patients with scleroderma at risk for digital ischemia is now possible with clinical assessment and autoantibody profiles. Because there are a variety of conditions that lead to digital ischemia, it is important to understand the pathophysiology underlying each ischemic presentation in order to target therapy appropriately. Significant progress has been made in the last 20 years in defining the pathophysiological processes leading to digital ischemia in rheumatic diseases. In this article we review the risk stratification, diagnosis and management of patients with digital ischemia and provide a practical approach to therapy, particularly in scleroderma.",
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