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  Vol. 143 No. 1, January 2007 TABLE OF CONTENTS
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VIGNETTES
Bosentan as a Rescue Therapy in Scleroderma Refractory Digital Ulcers

Melanie Chamaillard, MD; Isabelle Heliot-Hosten, MD; Joël Constans, MD; Alain Taïeb, MD

Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Ischemic digital ulcerations complicate 15% to 25% of cases of systemic sclerosis and can be difficult to treat with the usual vasodilators. Herein, we describe a patient with systemic sclerosis manifesting as digital ulcers refractory to conventional treatments who benefited from the new endothelin receptor antagonist bosentan (Tracleer; Actelion Pharmaceuticals Ltd, Allschwil, Switzerland).

Report of a Case

A 39-old-woman was seen with a 2-month history of very painful digital ulcerations on both hands and Raynaud phenomenon for 10 years. On physical examination, a mild sclerodactyly was noted without telangiectases (Figure 1). Arteriography showed bilateral distal arteriopathy with occlusion of the left ulnar artery and other digital arteries. Test results for antinuclear antibodies were positive at 1/2000 without detectable antigen specificity.


 
Figure appears in full text version.
Figure 1. Spontaneous digital ulcerations of the fingers.


After a complete diagnostic workup (including thoracic computed tomography, functional respiratory explorations . . . [Full Text of this Article]


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