Two faces of the same coin: Raynaud phenomenon and digital ulcers in systemic sclerosis

Autoimmun Rev. 2011 Mar;10(5):241-3. doi: 10.1016/j.autrev.2010.09.008. Epub 2010 Sep 21.


Systemic sclerosis (SSc) is characterized by wide-spread fibrosis, activation of immune system with production of autoantibodies and extensive vascular damage. Raynaud's phenomenon (RP) and digital ulcers (DU) represent two faces of the same coin in SSc vasculopathy. RP, the earliest manifestation of the vascular involvement, is due to an excessive vasospasm of digital arteries, precapillary arterioles and cutaneous arteriovenous shunts, usually in response to cold exposure or other stimuli. DU are a severe complication of microvessel involvement and also of the persistent vasospasm of RP. Thus, the management of RP and DU requires a multimodal approach using a combination of pharmacological, non-pharmacological, and surgical treatments. Currently, the treatment of these complications represents a great challenge for all physicians.

Publication types

  • Review

MeSH terms

  • Autoantibodies / biosynthesis
  • Cold Temperature
  • Combined Modality Therapy
  • Endothelium, Vascular / physiopathology
  • Fibrosis / complications
  • Fibrosis / physiopathology*
  • Fibrosis / therapy
  • Humans
  • Immune System Phenomena
  • Raynaud Disease / complications
  • Raynaud Disease / physiopathology*
  • Raynaud Disease / therapy
  • Scleroderma, Systemic / complications
  • Scleroderma, Systemic / immunology
  • Scleroderma, Systemic / physiopathology*
  • Scleroderma, Systemic / therapy
  • Skin / blood supply
  • Skin Ulcer / complications
  • Skin Ulcer / physiopathology*
  • Skin Ulcer / therapy
  • Spasm / physiopathology
  • Ulnar Artery / physiopathology
  • Vasoconstriction


  • Autoantibodies