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2019, Número 3

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Residente 2019; 14 (3)


Úlceras digitales en esclerosis sistémica progresiva: un reto diagnóstico y terapéutico

Cruz-Sandoval G, Salcedo-Hernández MJ,Toledo-Rasgado AA, Campirán-Gutiérrez J, Jiménez-Bulnes J, Zepeda-Álvarez LA, Vizcaíno-Cortez ZG, Rivero-Gallegos D, Becerra-Alvarado IN, González-López L, Gámez-Nava JI

Idioma: Español
Referencias bibliográficas: 68
Paginas: 73-86
Archivo PDF: 336.50 Kb.


RESUMEN

La esclerosis sistémica progresiva (ESP) es un trastorno autoinmunitario crónico caracterizado por inflamación multisistémica, daño vascular y fibrosis cutánea extensa y de otros órganos. Dentro de las principales manifestaciones clínicas de la esclerosis se encuentra el fenómeno de Raynaud, caracterizado por un vasoespasmo al frío u otros factores de estrés, afecta principalmente a arterias de mediano y pequeño calibre. Este fenómeno de Raynaud está asociado al desarrollo de complicaciones, incluyendo la aparición de úlceras digitales. Las úlceras digitales se presentan hasta en 50% de los pacientes con ESP, se asocian a la afección de órganos internos y a la gravedad de la enfermedad, dependiendo el tiempo de aparición determina el pronóstico de la misma. Esta revisión tiene como propósito describir las características clínicas de las úlceras digitales, identificar aspectos relevantes de la patogénesis y la importancia que tienen en la ESP, su aparición se ve asociada a un incremento en el riesgo de otras manifestaciones clínicas como afección cardiaca, hipertensión pulmonar, que a su vez perpetúa la aparición de las mismas, así como a un incremento de la mortalidad en pacientes con ESP. El manejo de las úlceras digitales sigue siendo un reto terapéutico, un tratamiento tardío y las secuelas que generan pueden condicionar a los pacientes a una discapacidad funcional grave, en cambio un tratamiento temprano, integral y oportuno constituye la medida más eficaz para la prevención de las úlceras digitales y las complicaciones que condicionan.


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