Peripheral Ischemic lesions in rheumatology: Presentation and outcomes

The Importance of Prompt Diagnosis and Management of Digital Gangrene Associated with Rheumatic Diseases

“…To conclude, the acumen to suspect, diagnose early and rapidly commence appropriate immunosuppressive, vasodilatory or antithrombotic therapy is indispensable for the preservation of digits in patients with gangrene. The study by Dhakad et al 1 serves as a critical reminder and reinforces the necessity of prompt action by rheumatologists faced with these ischaemic complications.…”

“…In the context of an acutely ischaemic limb or digit, treatment with heparin for 48–72 hours in the absence of any contraindications for the same may be warranted for its endothelial stabilising action. The findings by Dhakad et al 1 underscore the urgency of expedited referrals and treatment initiation. The sobering fact that over half of this patient cohort required amputation underscores the consequences of delayed medical intervention and late hospital presentation, often occurring when gangrene is already established, which invariably leads to poorer outcomes.…”

“…A few other studies had also evaluated the aetiologies of gangrene in the context of rheumatic diseases (summarised in Table 1). [1][2][3][4] The prevalence and prognosis of peripheral gangrene vary with the underlying rheumatic disease. As an example, in patients with systemic sclerosis, data from the EUSTAR cohort reveal that nearly a tenth of patients experience digital gangrene.…”

“…A few other studies had also evaluated the aetiologies of gangrene in the context of rheumatic diseases (summarised in Table 1). 1–4…”