Digital Ulcer as a Rare Complication of Systemic Lupus Erythematosus: A Case Report

Abstract

The two most common rheumatological diseases which accompany Raynaud's phenomenon are systemic sclerosis and systemic lupus erythematosus (SLE). Digital gangrene formation has no definitive etiology and pathogenesis, and Raynaud's phenomenon often accompanies the necrotic lesions associated with this skin condition. Macrovascular involvement is commonly found in systemic sclerosis, but is very rare in patients with SLE. In our case, we identified ulnar artery involvement in the absence of any other risk factors associated with digital gangrene formation. Raynaud's phenomenon is fairly common in SLE, but digital ulcers are seldomly seen. The most common cause of digital gangrene in SLE is antiphospholipid antibody syndrome (AAS). The risk factors for digital ulcers include duration of lupus, male gender, atherosclerosis, vasculitis, and AAS. Herein, we present a case with long-standing SLE who also had digital ulcers.

Earlier Development of Limb Ulcers, Digital Bone Infarction and Pulmonary Hypertension in a Patient with SLE- A Rare Case Report

“…The treatment of digital ulcers in patients with SLE includes Epoprostenol(Iloprost) infusion, bosentan and immunosuppressive therapy (Cyclophosphamide and pulse Methylprednisolone). 6 Unfortunately Epoprostenol(Iloprost) was not available, so could not be given to our patient. Cyclophosphamide was avoided intentionally because patient is married for one year and yet to conceive.…”

“…5 Although Raynaud's phenomenon is fairly common in patients with SLE, digital ulcers are quite rare. 6 Case Report: A 24 yrs old female normotensive, non-diabetic patient hailing from Sunamgonj, Sylhet was admitted in medicine department of Sylhet MAG Osmani medical college hospital on 3 rd March, 2016 with the complaints of multiple ulcers in both upper and lower limbs for 3 months, pain in multiple joints for 3 months, weakness and generalized muscular pain for 2 months. At first she noticed few blisters on her right leg which ruptured and turned into an ulcer.…”

Vasculitis and Antiphospholipid Syndrome in a Systemic Lupus Patient

“…Digital ulceration is a rare complication [15] however not unheard of. A past case featuring a 45-year-old female, with a 10-year history of SLE accompanied by Raynaud's phenomenon, can be found where the patient had severe pain, cyanosis and digital ulcers on her fingers [16].…”