Systemic Sclerosis — SCE Dermatology MCQ
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Correct answer: D — Intravenous Iloprost
Intravenous Iloprost (a prostacyclin analogue) has the strongest evidence for healing existing digital ulcers in systemic sclerosis and is recommended by EULAR/BAD guidelines. Bosentan (endothelin receptor antagonist) is effective for prevention of new digital ulcers but has less evidence for healing existing ones. Sildenafil and nifedipine help with Raynaud phenomenon but have weaker evidence for active ulcer healing. The distinction between ulcer prevention (Bosentan) and ulcer healing (Iloprost) is clinically important.
Reference: EULAR 2017 Recommendations for treatment of SSc; BAD 2016