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Raynaud s phenomenon and digital ischemia: a practical approach to risk
stratification, diagnosis and management
#MMPMID26523153
McMahan ZH
; Wigley FM
Int J Clin Rheumtol
2010[]; 5
(3
): 355-370
PMID26523153
show ga
Digital ischemia is a painful and often disfiguring event. Such an ischemic event
often leads to tissue loss and can significantly affect the patient's quality of
life. Digital ischemia can be secondary to a vasculopathy, vasculitis, embolic
disease, trauma, or extrinsic vascular compression. It is an especially serious
complication in patients with scleroderma. Risk stratification of patients with
scleroderma at risk for digital ischemia is now possible with clinical assessment
and autoantibody profiles. Because there are a variety of conditions that lead to
digital ischemia, it is important to understand the pathophysiology underlying
each ischemic presentation in order to target therapy appropriately. Significant
progress has been made in the last two decades in defining the pathophysiological
processes leading to digital ischemia in rheumatic diseases. In this article we
review the risk stratification, diagnosis, and management of patients with
digital ischemia and provide a practical approach to therapy, particularly in
scleroderma.
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