Maricq HR, Smith EA: “Organ Involvement: Peripheral Vascular,” in Systemic Sclerosis, ed by PJ Clements, DE Furst, p 365, Williams & Wilkins, Baltimore, 1996..
Rodnan GP, Myerowitz RL, Justh GO: Morphologic changes in the digital arteries of patients with progressive systemic sclerosis (scleroderma) and Raynaud phenomenon. .Medicine 59::393. ,1980. .
von Bierbrauer A, Barth P, Willert J, et al: Electron microscopy and capillaroscopically guided nailfold biopsy in connective tissue diseases: detection of ultrastructural changes of the microcirculatory vessels. .Br J Rheum 37::1272. ,1998. .
Ames PR, Lupoli S, Alves J, et al: The coagulation/fibrinolysis balance in systemic sclerosis: evidence for a haematological stress syndrome. .Br J Rheum 36::1045. ,1997. .
Maricq HR: Wide-field capillary microscopy: technique and rating scale for abnormalities seen in scleroderma and related disorders. .Arthritis Rheum 24::1159. ,1981. .
Clements PJ, Medsger TA Jr: “Organ Involvement: Skin,” in Systemic Sclerosis, ed by PJ Clements, DE Furst, p 389, Williams & Wilkins, Baltimore, 1996..
Milburn PB, Singer JZ, Milburn MA: Treatment of scleroderma skin ulcers with a hydrocolloid membrane. .J Am Acad Dermatol 21::200. ,1989. .
Zachariae H, Halkier-Sorensen L, Bjerring P, et al: Treatment of ischaemic digital ulcers and prevention of gangrene with intravenous iloprost in systemic sclerosis. .Acta Derm Venereol 76::236. ,1996. .
Woo TY, Wong RC, Campbell JP, et al: Nifedipine in scleroderma ulcerations. .Int J Dermatol 23::678. ,1984. .
Ames PR, Stephens JW, Steuer A, et al: Prolonged healing of malleolar ulcers after fibrinolytic treatment in a woman with systemic sclerosis. .Br J Rheumatol 37::107. ,1998. .
Hafner J, Kohler A, Enzler M, et al: Successful treatment of an extended leg ulcer in systemic sclerosis. .Vasa 26::302. ,1997. .
Dorevitch MI, Clemens LE, Webb JB: Lower limb amputation secondary to large vessel involvement in scleroderma. .Br J Rheumatol 27::403. ,1988. .
Filho JP, Sampaio-Barros PD, Parente JB, et al: Rhythmic external compression of the limbs: a method for healing cutaneous ulcers in systemic sclerosis. .J Rheumatol 25::1540. ,1998. .
Platelet-derived growth factor for diabetic ulcers. .Med Lett Drugs Ther 40::73. ,1998. .
LeGrand EK: Preclinical promise of becaplermin (rhPDGF-BB) in wound healing. .Am J Surg 176:: (suppl 2A)48S. ,1998. .
Wieman TJ, Smiell JM, Su Y: Efficacy and safety of a topical gel formulation of recombinant human platelet-derived growth factor-BB (becaplermin) in patients with chronic neuropathic diabetic ulcers. .Diabetes Care 21::822. ,1998. .
Skin ulcers can be very painful and detrimental in patients with systemic sclerosis, or systemic scleroderma. A brief review of scleroderma skin ulcers is presented, as well as a case study that demonstrates the effectiveness of becaplermin gel supplemented by oral immunosuppressive agents in the treatment of ulcers resulting from systemic sclerosis. The time to healing (approximately 3 months) was comparable to that associated with the oral agents and surgical interventions specifically designed to help heal scleroderma ulcers. Except for incisional biopsy, no surgical procedures were performed. (J Am Podiatr Med Assoc 92(6): 350-354, 2002)