Exploring the patient experience of digital ulcers in systemic sclerosis

Michael Hughes, John D Pauling

Research output: Contribution to journalReview articlepeer-review

28 Citations (SciVal)
83 Downloads (Pure)


Digital ulcers are common in patients with systemic sclerosis, affecting over half of patients during the course of their disease. For some patients, digital ulcers occur as isolated phenomena; whereas, for others, digital ulceration is recurrent, and often refractory to intervention. Demonstrating treatment efficacy for digital ulcer disease has typically focussed on clinician opinion of ulcer healing and new ulcer occurrence. Advances in management have improved outcomes which may have had the unfortunate effect of rendering traditional trial endpoints less effective at demonstrating treatment efficacy. Despite recent improvements in management, our work is not complete and digital ulceration remains a major cause of morbidity for many patients with systemic sclerosis. This review shall examine the patient experience of digital ulcers in systemic sclerosis. We shall consider how a detailed understanding of the severity and burden of digital ulceration, aetiopathogenesis, and their impact on emotional health, function, work and social participation might inform the development of novel clinical trial outcomes that can support future advances in the assessment and management of digital ulceration in systemic sclerosis.

Original languageEnglish
Pages (from-to)888-894
Number of pages7
JournalSeminars in Arthritis and Rheumatism
Issue number5
Early online date11 Aug 2018
Publication statusPublished - 1 Apr 2019


  • Activities of Daily Living
  • Disability Evaluation
  • Fingers
  • Humans
  • Quality of Life
  • Scleroderma, Systemic/complications
  • Severity of Illness Index
  • Skin Ulcer/etiology


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