Alternative Therapeutic Approaches in Skin Ulcers Due to Systemic Sclerosis

  • Nabil George
  • Todd Kanzara
  • Kuntal Chakravarty


Digital ulcerations (DU) are a frequent presentation and complication of systemic sclerosis caused by sudden acute critical tissue ischaemia of the upper and or lower limb extremities. DU can be a cause of significant painful disability, often interfering with quality of life. Management of patients with DU requires considerable time and resources. Most patients respond to conventional therapies of vasodilatation as described earlier; however, this chapter will focus on the alternative therapeutic approaches that may be considered in rare cases when conventional methods fail. A small proportion of patients may require such alternative therapies, most likely alongside conventional methods. There is a paucity of more robust evidence such as randomised controlled studies to support the use of alternative treatments. Alternative therapies may be considered more complimentary than truly ‘alternative’ options and may perform better in combination with conventional therapies depending on the severity of the illness.


Alternative Hyperbaric Oxygen Botulinum Tocopherol Vitamin e Nitric oxide Pneumatic compression Ultrasound Iontophoresis Maggot Myiasis Herbal Remedies 


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Nabil George
    • 1
  • Todd Kanzara
    • 2
  • Kuntal Chakravarty
    • 3
  1. 1.Medicine/Surgery, North Middlesex University HospitalLondonUK
  2. 2.Otolaryngology, Southend HospitalSouthendUK
  3. 3.Rheumatology, Royal Free Hospital NHS Foundation TrustLondonUK

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