Successful Treatment with Bosentan of Lower Extremity Ulcers in a Scleroderma Patient

Digital ulcers are a well-known problem in patients with systemic sclerosis. Lower extremity ulcers are less prevalent but are also a challenging and underestimated complication of the disease causing important pain and morbidity. Bosentan, an oral dual endothelin receptor antagonist, has been shown...

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Main Authors: Alix Naert, Petra De Haes
Format: Article
Language:English
Published: Wiley 2013-01-01
Series:Case Reports in Medicine
Online Access:http://dx.doi.org/10.1155/2013/690591
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author Alix Naert
Petra De Haes
author_facet Alix Naert
Petra De Haes
author_sort Alix Naert
collection DOAJ
description Digital ulcers are a well-known problem in patients with systemic sclerosis. Lower extremity ulcers are less prevalent but are also a challenging and underestimated complication of the disease causing important pain and morbidity. Bosentan, an oral dual endothelin receptor antagonist, has been shown to be effective in preventing digital ulcers in patients with systemic sclerosis. A few recent observations showed the efficacy of bosentan for accelerating the healing of nondigital ulcers in scleroderma patients. This report deals with a 48-year-old patient with systemic sclerosis who developed painful ulcers on the left ankle and hallux. The ulcers were refractory to a combination of vasodilator therapy with a calcium antagonist and several courses of intravenous prostanoids, low molecular weight heparin, aspirin, simvastatin, and intensive local treatment. Bosentan treatment showed spectacular healing of the ulcers already after 4 months of therapy. This case supports the previous few observations of accelerating wound healing of lower extremity ulcers in systemic sclerosis patients with bosentan treatment.
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spelling doaj-art-deaf504c7e6745a7826fcc3028f8dfb32025-08-20T03:26:16ZengWileyCase Reports in Medicine1687-96271687-96352013-01-01201310.1155/2013/690591690591Successful Treatment with Bosentan of Lower Extremity Ulcers in a Scleroderma PatientAlix Naert0Petra De Haes1Department of Dermatology, University Hospital, KU Leuven, Kapucijnenvoer 33, 3000 Leuven, BelgiumDepartment of Dermatology, University Hospital, KU Leuven, Kapucijnenvoer 33, 3000 Leuven, BelgiumDigital ulcers are a well-known problem in patients with systemic sclerosis. Lower extremity ulcers are less prevalent but are also a challenging and underestimated complication of the disease causing important pain and morbidity. Bosentan, an oral dual endothelin receptor antagonist, has been shown to be effective in preventing digital ulcers in patients with systemic sclerosis. A few recent observations showed the efficacy of bosentan for accelerating the healing of nondigital ulcers in scleroderma patients. This report deals with a 48-year-old patient with systemic sclerosis who developed painful ulcers on the left ankle and hallux. The ulcers were refractory to a combination of vasodilator therapy with a calcium antagonist and several courses of intravenous prostanoids, low molecular weight heparin, aspirin, simvastatin, and intensive local treatment. Bosentan treatment showed spectacular healing of the ulcers already after 4 months of therapy. This case supports the previous few observations of accelerating wound healing of lower extremity ulcers in systemic sclerosis patients with bosentan treatment.http://dx.doi.org/10.1155/2013/690591
spellingShingle Alix Naert
Petra De Haes
Successful Treatment with Bosentan of Lower Extremity Ulcers in a Scleroderma Patient
Case Reports in Medicine
title Successful Treatment with Bosentan of Lower Extremity Ulcers in a Scleroderma Patient
title_full Successful Treatment with Bosentan of Lower Extremity Ulcers in a Scleroderma Patient
title_fullStr Successful Treatment with Bosentan of Lower Extremity Ulcers in a Scleroderma Patient
title_full_unstemmed Successful Treatment with Bosentan of Lower Extremity Ulcers in a Scleroderma Patient
title_short Successful Treatment with Bosentan of Lower Extremity Ulcers in a Scleroderma Patient
title_sort successful treatment with bosentan of lower extremity ulcers in a scleroderma patient
url http://dx.doi.org/10.1155/2013/690591
work_keys_str_mv AT alixnaert successfultreatmentwithbosentanoflowerextremityulcersinasclerodermapatient
AT petradehaes successfultreatmentwithbosentanoflowerextremityulcersinasclerodermapatient