Øyvind Midtvedt | PubMed Health

PubMed2006

[Ischemic ulcers in systemic connective tissue disorders].

BACKGROUND: Ischemic ulcers (digital ulcers) are often observed in systemic connective tissue disorders. MATERIAL AND METHODS: This review article is based on a Pubmed search with the terms "digital ulcers" and "ischemic ulcers", and on the authors' clinical experience. RESULTS AND INTERPRETATION: Up to 40 % of patients with systemic sclerosis have digital ulcers. Non-rheumatic causes of compromised blood circulation must be excluded. The treatment consists of analgesics, prevention of cooling and antibiotics if the ulcers are infected. Other possible treatments are vasodilators, prostacyclin analogues, endothelin receptor antagonists, sildenafil and chemical or surgical sympathectomy.

Connective Tissue Diseases↗

PubMed2005

[Pathophysiologic aspects of systemic sclerosis].

BACKGROUND: The pathological changes in systemic sclerosis are characterised by severe organ fibrosis, obliteration of arteries and arterioles and disturbance of immunological functions. Recent research has yielded new insight into the complex pathogenesis of systemic sclerosis, with new therapeutic options as a possible consequence. MATERIALS AND METHODS: Relevant medical literature has been reviewed. RESULTS: The pathological deposition of extracellular matrix in systemic sclerosis is most probably caused by changes in the regulation of dermal fibroblasts. The review focuses on three of the many molecules involved in the regulation of fibrosis; Transforming growth factor beta, Connective tissue growth factor and Endothelin-1. INTERPRETATION: Treatment of organ-specific disease complication has for long remained the only therapeutic option in systemic sclerosis. Based on current knowledge of the process of fibrosis, new therapeutic trials employing substances directed towards pro-fibrotic molecules are now in progress.

Connective Tissue Growth Factor↗