Systemic sclerosis — SCE Rheumatology MCQ

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HardConnective tissue diseasesSystemic sclerosisSCE Rheumatology

A patient with systemic sclerosis has recurrent digital ulcers despite effective calcium-channel-blocker treatment and careful cold avoidance. Which oral treatment is recommended for ulcer healing when clinically suitable?

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Correct answer: D — Sildenafil

The best answer is “Sildenafil”. A phosphodiesterase-5 inhibitor such as sildenafil is recommended in UK systemic-sclerosis guidance to promote digital-ulcer healing when first-line vasodilator measures are insufficient and contraindications have been considered. Warfarin, methotrexate, allopurinol and alendronate do not provide targeted digital vasodilation or ulcer healing.

Reference: BSR systemic sclerosis guideline: https://pmc.ncbi.nlm.nih.gov/articles/PMC11534099/