Management of Raynaud's phenomenon and digital ischemic lesions in scleroderma

Rheum Dis Clin North Am. 2003 May;29(2):293-313. doi: 10.1016/s0889-857x(03)00019-x.


Raynaud's phenomenon is a challenging problem in patients who have scleroderma. It causes a great deal of morbidity with recurrent painful attacks and frequent digital ischemic lesions. The strategy to treat the vascular disease must consider treatment for the vasospasm and the intrinsic vascular disease with intimal proliferation and vessel occlusion. Vasodilator therapy remains the main method to treat Raynaud's phenomenon, but new understanding of the pathobiology of scleroderma vascular disease is providing novel treatment options. We need more investigations into these vasoactive drugs before routine use can be recommended. Critical ischemia can cause deep tissue injury and digital loss. An aggressive approach to reversing an ischemic crisis is essential for preventing these severe events.

Publication types

  • Review

MeSH terms

  • Fingers / blood supply
  • Fingers / pathology
  • Humans
  • Ischemia / etiology
  • Ischemia / pathology
  • Ischemia / therapy*
  • Raynaud Disease / etiology
  • Raynaud Disease / pathology
  • Raynaud Disease / therapy*
  • Scleroderma, Systemic / complications
  • Scleroderma, Systemic / pathology
  • Scleroderma, Systemic / therapy*
  • Skin / blood supply
  • Skin / pathology
  • Skin / physiopathology