{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T06:52:13Z","timestamp":1789887133653,"version":"4.0.1"},"reference-count":10,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2017,3,16]],"date-time":"2017-03-16T00:00:00Z","timestamp":1489622400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Wound Journal"],"published-print":{"date-parts":[[2017,12]]},"abstract":"Abstract<\/jats:title>Ischaemic digital ulcers (DUs<\/jats:styled-content>) are an indicator of the severity of the microangiopathy in patients with systemic sclerosis (SSc<\/jats:styled-content>). DUs<\/jats:styled-content> are a frequent complication, affecting about 50% of patients with SSc<\/jats:styled-content>, and are often recurrent. In cross\u2010sectional studies involving patients with SSc<\/jats:styled-content>, the frequency of ischaemic DUs<\/jats:styled-content> was 12\u201316% with a major impact on hand function and quality of life. Effective therapy for DUs<\/jats:styled-content> remains elusive. Intravenous iloprost has been demonstrated to have a positive effect on healing of active DUs<\/jats:styled-content>. Bosentan, an oral endothelin receptor antagonist, only showed a benefit in preventing the occurrence of new DUs<\/jats:styled-content>. Despite limited evidence, recent guidelines have recommended phosphodiesterase type 5 inhibitors as an option. Injection of botulinum toxin and digital sympathectomy have been increasingly used for ischaemic DUs<\/jats:styled-content>. Here we present the complex case of a SSc<\/jats:styled-content> patient already treated with sildenafil and bosentan in whom an active DU<\/jats:styled-content> was successfully treated with botulinum toxin A. Despite the lack of a randomised controlled trial, results are encouraging for the use of botulinum toxin in the treatment of DUs<\/jats:styled-content> and could perhaps help to avoid some amputations, as in the present case.<\/jats:p>","DOI":"10.1111\/iwj.12742","type":"journal-article","created":{"date-parts":[[2017,3,17]],"date-time":"2017-03-17T01:56:45Z","timestamp":1489715805000},"page":"978-981","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Non\u2010healing ischaemic digital ulcer in a systemic sclerosis patient: a challenging clinical case"],"prefix":"10.1111","volume":"14","author":[{"given":"Sophie","family":"Blaise","sequence":"first","affiliation":[{"name":"Vascular Medicine Department Grenoble University Hospital Grenoble France"},{"name":"UMR 1042\u2013HP2 INSERM and University Grenoble\u2010Alpes Grenoble France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthieu","family":"Roustit","sequence":"additional","affiliation":[{"name":"UMR 1042\u2013HP2 INSERM and University Grenoble\u2010Alpes Grenoble France"},{"name":"Clinical Pharmacology Unit, INSERM CIC1406 Grenoble Alps University Hospital Grenoble France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Forli","sequence":"additional","affiliation":[{"name":"Hand Surgery Department Grenoble Alps University Hospital Grenoble France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard","family":"Imbert","sequence":"additional","affiliation":[{"name":"Vascular Medicine Department Grenoble University Hospital Grenoble France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean\u2010Luc","family":"Cracowski","sequence":"additional","affiliation":[{"name":"UMR 1042\u2013HP2 INSERM and University Grenoble\u2010Alpes Grenoble France"},{"name":"Clinical Pharmacology Unit, INSERM CIC1406 Grenoble Alps University Hospital Grenoble France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,3,16]]},"reference":[{"key":"e_1_2_5_2_1","first-page":"2423","article-title":"Natural history of ischemic digital ulcers in systemic sclerosis: single\u2010center retrospective longitudinal study","volume":"34","author":"Hachulla E","year":"2007","journal-title":"J Rheumatol"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.081044"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2011-200631"},{"key":"e_1_2_5_5_1","first-page":"1","article-title":"Update of EULAR recommendations for the treatment of systemic sclerosis","volume":"74","author":"Kowal\u2010Bielecka O","year":"2016","journal-title":"Ann Rheum Dis"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2013.06.029"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2014-207001"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anplas.2011.11.001"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/1346-8138.13030"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/1753193413516242"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.5114\/aoms.2015.48152"}],"container-title":["International Wound Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fiwj.12742","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/iwj.12742","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T11:16:44Z","timestamp":1696504604000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/iwj.12742"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,3,16]]},"references-count":10,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2017,12]]}},"alternative-id":["10.1111\/iwj.12742"],"URL":"https:\/\/doi.org\/10.1111\/iwj.12742","archive":["Portico"],"relation":{},"ISSN":["1742-4801","1742-481X"],"issn-type":[{"value":"1742-4801","type":"print"},{"value":"1742-481X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,3,16]]},"assertion":[{"value":"2016-12-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-02-26","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-03-16","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}