Article Text

Download PDFPDF
Clinical burden of digital vasculopathy in limited and diffuse cutaneous systemic sclerosis
  1. S I Nihtyanova,
  2. G M Brough,
  3. C M Black,
  4. C P Denton
  1. Centre for Rheumatology, Royal Free Hospital, Pond Street, London, UK
  1. Professor C P Denton, Centre for Rheumatology, Royal Free Hospital, Pond Street, London NW3 2QG, UK; c.denton{at}


Background: Vascular damage is a key pathological process in systemic sclerosis (SSc) and accounts for significant disease-related morbidity. To determine the clinical burden of severe digital vasculopathy (SDV), we have reviewed hospital-based treatment for this important complication of SSc in a large single centre cohort.

Methods: Cases were identified from a cohort of 1168 patients with a diagnosis of SSc who were reviewed during an 18-month period. Patients with recorded episodes of SDV-related complications (digital ulceration, critical digital ischaemia or digital gangrene), requiring surgical amputation, digital sympathectomy or admissions for intravenous prostacyclin or calcitonin gene related peptide (CGRP) and/or intravenous antibiotic treatment were identified.

Results: From this large SSc cohort, 17.4% had SDV-related complications. Contrary to expectation, their frequency was significantly higher among the patients with the diffuse cutaneous subset of SSc (27.5%) compared with 13% among the patients with limited cutaneous SSc (p<0.0001). 16.6% had at least one recorded episode of digital ulcers, and 12% required at least one hospitalisation during the 18 months for treatment with intravenous prostacyclin/CGRP. Overall, there were 242 admissions with a mean duration of 6 days.

Conclusions: Digital vasculopathy is a serious complication of SSc contributing significant morbidity and often requiring hospital-based management.

View Full Text

Statistics from


  • Competing interests: None declared.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.