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Rasche Abheilung von akralen Ulzera bei systemischer Sklerodermie unter Sildenafil

Fast and efficient healing of scleroderma-associated acral ulcers with sildenafil

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Zusammenfassung

Ulzera bei sekundärem Raynaud-Syndrom bei PSS sind häufig therapieresistent. Sildenafil, ein Phosphodiesterase-5-Hemmer, dilatiert kleine Gefäße durch cGMP-Erhöhung. Die orale Behandlung eines 35-jährigen Patienten mit schwerer systemischer Sklerodermie, assoziiertem PAH und akralen Ulzera mit Sildenafil reduzierte in einer Woche klinisch signifikant die Dyspnoe mit Zunahme der Gehstrecke. In 5 Wochen heilten die akralen Ulzera vollständig und lang anhaltend ab. Sildenafil könnte für den Dermatologen eine neue therapeutische Option bei therapieresistenten akralen Ulzera der PSS darstellen.

Abstract

Acral ulcers in patients with progressive systemic sclerosis (PSS) are often recalcitrant to therapy. Sildenafil, an inhibitor of phosphodiesterase-5, dilates small arteries by increasing endothelial cGMP. Oral administration of sildenafil to a 35-year-old white male patient suffering from incapacitating PSS with severe pulmonary arterial hypertension and acral ulcers induced a clinically significant reduction in dyspnea and increase in walking distance within one week as well as complete and long-lasting healing of all ulcers within five weeks. This case demonstrates the efficacy of sildenafil in the treatment of scleroderma-associated refractory acral ulcers.

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Abbreviations

BSG:

Blutkörperchensenkungsgeschwindigkeit

EKG:

Elektrokardiographie

HEp-2:

Human epitheloid cell line: type 2

IIF:

Indirekte Immunfluoreszenz

PAH:

Pulmonal arterieller Hypertonus

PDE-5:

Phosphodiesterase Typ 5

PSS:

Progressive systemische Sklerodermie

pro-BNP:

pro-Brain-natriuretic Peptide

RVSP:

Rechtsventrikulärer systolischer Druck

TTE:

Transthorakale Echokardiographie

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Authors and Affiliations

  1. Klinik und Poliklinik für Dermatologie, Medizinische Fakultät der Technischen Universität Dresden, Fetscherstraße 74, 01207, Dresden, Deutschland

    E. Friedrichson, P. Rehberger, M. Meurer &  C. Pfeiffer

  2. Klinik für Innere Medizin II-Kardiologie, Medizinische Fakultät der Technischen Universität Dresden, Dresden, Deutschland

    J.T. Fuhrmann & F. Walz

Authors
  1. E. Friedrichson
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  2. P. Rehberger
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  3. J.T. Fuhrmann
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  4. F. Walz
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  5. M. Meurer
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  6. C. Pfeiffer
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Corresponding author

Correspondence to C. Pfeiffer.

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Friedrichson, E., Rehberger, P., Fuhrmann, J. et al. Rasche Abheilung von akralen Ulzera bei systemischer Sklerodermie unter Sildenafil. Hautarzt 59, 230–232 (2008). https://doi.org/10.1007/s00105-007-1366-1

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  • DOI: https://doi.org/10.1007/s00105-007-1366-1

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