digital ulcers/sores

[Brychni]

Hello all

I had thought that I would have some answers to questions that I was going to ask rheumatologist yesterday, but my appointment was cancelled. So ...

A few months ago I had, on the tip of my index finger what I am pretty certain was a digital ulcer. It went through all its stages and left hard skin with a bit of pitting. Now there is another one on the way.

I was diagnosed a few years ago with Undifferentiated Inflammatory ARthritis and have been taking hydroxychloroquine since then. (I'm 53). I had synovial inflammation on a scan and positive (twice) for antibeta2 glycoprotein 1 Igg. My platelets are also low (but not that low) - sometimes also low white.

Since about the age of 17 I first started to get Raynaud's, but only in my nipples and only when pregnant. In my fingers really only kicked off when I was about 40/41 and got progressively worse over the follwoing years. Not sure if it is becasue o the hydroxyc. but severe attacks of it have pretty much stopped although it does still happen and is a lot more painful than it ever used to be also tends to be after shower, hanging wet washing etc. Have learned to always use rubber gloves and have been slathering Vaselinge and lanolin on my fingers for years, even before it started to get bad.

I've discovered, by accident, that my diagnosis has changed to Connective Tissue Disease with lupus. Still haven't had a chance to discuss this with the rheuamtologist.

So - that's my history! Can anyone tell me what these sores on my fingers are? Is it the beginning of something, is it a different symptom of Raynaud's? The new one is in the same place but still a red/purple spot under the skin but just like the first one already quite painful.

Thanks.

[OldTed60]

How annoying that your rheumatology review was cancelled. Have you been given a replacement date yet? I don’t get ulcers but I did have similar looking spots to yours prior to starting Iloprost infusions and Mycophenolate. I think they were some type of a small vessel Vasculitis relating to my Erythromelalgia/ Raynaud’s overlap. This is certainly what my rheumatologist thought and she had my cryoglobulins tested and arranged a depomedrome injection as my inflammation was very high. It took 3 more years for my systemic sclerosis to show in my nailfold capilliaries at Royal Free last year. I think Vasculitis is a common secondary to Sjögren’s and to systemic sclerosis - both of which I’m now diagnosed with

[hunkyd0ry]

Hi Brychni. It looks like it might be a digital ulcer.I get them regularly as part of my scleroderma and know how horrible and painful they are.

They are caused by some tissue not receiving enough blood supply due to constriction of the small blood vessels in that area, and for the same reason they are not healing very quickly either. The dark spot indicates that there is some tissue that died. Eventually it will heal and the dark stuff gets pushed out as a scab, leaving a little pit behind.

What helps in my case is taking Sildenafil (essentially viagra), which helps to open the blood vessels. I can take up to 150mg per day and vary the dose myself, depending on how bad I am.

If I up my dose, I can see a clear improvement within 2 days normally!

In bad periods I get Iloprost infusions over several days.

Please push for an appointment and speak to your rheumatologist as soon as possible.

You do want those ulcers treated!

[Lupiknits]

Ouch! They look very like the digital ulcers I developed during lockdown. Mine progressed in the same way as hunkydOry described. In my case it’s the result of the Raynaud’s. You don’t seem to be on any medication for it. Your GP might be able to help with that. I couldn’t tolerate oral meds but now have Iloprost infusions every month. Even then the ulcers can start in the coldest months. x