Digital ulcers associated with scleroderma: A major unmet medical need

Abstract

Scleroderma or systemic sclerosis (SSc)‐associated digital ischaemic complications, such as digital ulcers (SSc‐DUs), appear relatively early during the disease course and are a major burden with substantial deterioration of quality of life. Expert rheumatologist and wound specialists have defined a DU; however, international application of the definition is still disorganised. Appearance of SSc‐DUs is secondary to the onset of Raynaud's phenomenon and as a consequence, recommended first‐line of treatment mainly includes vasodilators; however, many DUs are refractory to this treatment. Despite important practical issues, such as a lack of well‐characterised SSc‐wound healing animal model, significant efforts are needed to mechanistically understand the pathogenesis of SSc‐DUs for developing clinically targetable disease modifying therapies.