Scleroderma skin ulcers

Scleroderma skin ulcers are challenging to manage and can be approached with a variety of therapies and treatments, according to a Professor of  Dermatology and Medicine in the Department of Medicine at the University of Alberta in Edmonton, speaking at the annual meeting of the Canadian Association of Wound Care (CAWC).

Managing numerous systemic diseases that produce wounds and ulcers such as scleroderma, pyoderma gangrenosum, necrobiosis lipoidica and vasculitis may require the use of systemic medications, says Alain Brassard, M.D., FRCPC. Dressings are not sufficient to treat wounds and ulcers associated with numerous systemic diseases, says Dr. Brassard.

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In the case of scleroderma of the skin, approximately 35% of patients will eventually get cutaneous ulcers, according to Dr. Brassard, whose work has been done in collaboration with Michelle Ramien, M.D., FRCPC, a dermatologist in Ottawa.

"Scleroderma is a disease that is systemic and needs to be treated systemically to heal the ulcers," says Dr. Brassard, in an interview with Dermatology Times. "The ulcers are related to endothelial cells that are driving the scleroderma. Raynaud's phenomenon is usually present in many patients with scleroderma. That phenomenon may create digital ulcers that are horrible in terms of the impact on quality of life of patients."

Digital ulcers are typically caused by minor trauma in a context of progressive ischemia which creates skin changes, explains Dr. Brassard.

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