Zusammenfassung
Patienten mit systemischer Sklerodermie (SSc) zeigen häufig akrale Ulzera, die sich durch eine ausgeprägte Therapieresistenz auszeichnen. Häufig kommt es zu einer Gangrän und zur Amputation. In unserer Klinik wurden 5 Patienten mit systemischer Sklerodermie sowie 1 Patient mit Mischkollagenose, die zuvor zahlreiche Therapien ohne Erfolg durchlaufen haben, systemisch mit Iloprostinfusionen behandelt. Alle Patienten litten unter einem Raynaud-Phänomen, akralen Ulzera sowie Nekrosen. Iloprost wurde in einer Dosierung von 25 µg pro Tag über 6 h an 10 aufeinander folgenden Tagen intravenös appliziert. Acht Wochen später wurde ein weiterer Zyklus über 5 Tage angeschlossen. Zwei Patienten wurden ein weiteres Mal therapiert, ebenfalls über 5 Tage, bis es zu einer Remission kam. Bei allen Patienten kam es zu einer vollständigen Abheilung der akralen Ulzera, kein Patient zeigte eine Verschlechterung über einen Nachbeobachtungszeitraum von 6 Monaten.
Abstract
Patients with systemic sclerosis (SSc) develop often acral ulcers which are resistant to therapy and may result in gangrene and amputation. We investigated the effects of iloprost infusion on the acral ulcers and necrosis in patients with five patients with SSc and one with mixed connective tissue disease who had been previously treated with various modalities without improvement. All patients had Raynaud phenomenon, acral ulcers and necrosis. Iloprost 25 µg per day was administered intravenously daily over six hours for ten consecutive days. Eight weeks later all patients were treated with a second iloprost therapy cycle for five days. Two patients with severe ulceration received a third cycle until remission occurred. In all cases acral ulcers healed completely and no patient relapsed during an observation period of 6 months.
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von Schmiedeberg, S., Artik, S., Assmann, T. et al. Behandlung therapieresistenter akraler Ulzera mit Iloprost. Hautarzt 55, 1150–1153 (2004). https://doi.org/10.1007/s00105-004-0844-y
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DOI: https://doi.org/10.1007/s00105-004-0844-y