Locoregional Treatments for Digital Ulcers in Systemic Sclerosis: A Systematic Review

source extracted confidence: high 2026-04-09
#humans #pain #scleroderma-systemic #skin-ulcer #ulcer

Locoregional Treatments for Digital Ulcers in Systemic Sclerosis: A Systematic Review

Costedoat et al., 2021 | Acta Derm Venereol | Systematic Review

Citation

Costedoat Ingrid, Masson Maeva, ... Truchetet Marie-Elise. Locoregional Treatments for Digital Ulcers in Systemic Sclerosis: A Systematic Review. Acta Derm Venereol. 2021-Jun-22;101(6):adv00478. doi:10.2340/00015555-3839

Abstract

The management of digital ulcers in systemic sclerosis is difficult. While the 2017 European League Against Rheumatism (EULAR) guidelines clearly defined the use of systemic therapies for digital ulcers, little is known about the efficacy of locoregional treatments. The aim of this review is to systematically assess the spectrum of published locoregional therapies for digital ulcers. A total of 58 studies were included. Among the different locoregional treatment strategies described, injections of fat-derived cells and botulinum toxin showed promising results in the reduction of pain and the number of digital ulcers. By contrast, this review found that sympathectomy yielded disappointing results, with low rates of effectiveness and frequent recurrence. For other treatments, such as hyperbaric oxygen therapy, phototherapy (ultraviolet A), low-level light therapy, intermittent compression, Waon therapy, extracorporeal shockwave, vitamin E gel, and topical dimethyl sulphoxide, the conflicting results or limited published data reflected the low level of evidence. Larger randomized clinical trials are required to confirm the validity of promising techniques.

Key Findings

Larger randomized clinical trials are required to confirm the validity of promising techniques.

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population See abstract
Sample Size 58
Age Range See abstract
Condition See abstract

MeSH Terms

  • Humans
  • Pain
  • Scleroderma, Systemic
  • Skin Ulcer
  • Ulcer

Evidence Classification

  • Level: Systematic Review
  • Publication Types: Journal Article, Systematic Review
  • Vertical: vitamin-e

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09