Locoregional Treatments for Digital Ulcers in Systemic Sclerosis: A Systematic Review.
botulinum toxin
digital ulcers
fat-derived cells
systematic review
systemic sclerosis
Journal
Acta dermato-venereologica
ISSN: 1651-2057
Titre abrégé: Acta Derm Venereol
Pays: Sweden
ID NLM: 0370310
Informations de publication
Date de publication:
22 Jun 2021
22 Jun 2021
Historique:
pubmed:
28
5
2021
medline:
24
6
2021
entrez:
27
5
2021
Statut:
epublish
Résumé
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.
Identifiants
pubmed: 34043013
doi: 10.2340/00015555-3839
pmc: PMC9380280
doi:
Types de publication
Journal Article
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
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