Catarsi E, Doveri M, Tavoni A
U.O. Immunoallergologia, Ospedale S. Chiara, Pisa, Italy.
Reumatismo. 2013 May 27;65(2):79-81. doi: 10.4081/reumatismo.2013.79.
Systemic sclerosis is an inflammatory disease of the connective tissue characterized by vasculopathy and accumulation of collagen and other components of the connective matrix, affecting the skin and internal organs. The appearance of skin ulcers as a result of vascular damage is very common in the history of the disease. Skin ulcers, painful and slow healing due to atrophy and local ischemia, get worse the quality of life of patients. Often, the use of conventional therapies (such as calcium channel blockers and prostanoids) does not cause the complete healing of the lesions. We report the case of a patient in whom therapeutic association between endothelin antagonist (bosentan) and phosphodiesterase-V inhibitor (sildenafil) resulted in complete healing of old ulcers both to upper and lower limbs and allowed the interruption of intravenous therapies.
系统性硬化症是一种结缔组织炎症性疾病，其特征为血管病变以及胶原蛋白和结缔组织基质其他成分的积聚，可累及皮肤和内脏器官。在该疾病的病程中，血管损伤导致皮肤溃疡的出现非常常见。由于萎缩和局部缺血，皮肤溃疡疼痛且愈合缓慢，会降低患者的生活质量。通常，使用传统疗法（如钙通道阻滞剂和前列腺素）并不能使病变完全愈合。我们报告了一例患者，其内皮素拮抗剂（波生坦）与磷酸二酯酶 -V 抑制剂（西地那非）联合治疗使上下肢的陈旧性溃疡完全愈合，并得以中断静脉治疗。
