Atlas of Digital Ulcers and Lesions

Abstract

The involvement of the microcirculation is an early pathogenetical hallmark of systemic sclerosis. This feature provokes not only the dysregulation of the vascular tone, known as Raynaud’s phenomenon, but also the sufferance of the tissues of the extremities. The vessel narrowing, the paucity of the blood flow and of the tissue irroration, leads inexorably to the progressive loss of dermal elasticity and to the formation of pitting scars. Eventually, the clinical picture can evolve to ulcers on fingers and in most severe cases to necrosis and gangrene which jeopardises the integrity of the finger or the limb. In these cases, amputation is the most feared complication.

In this atlas, we present the various features of digital ulcers, of calcinosis, of digital pitting scars and of necrosis and gangrene.