The Scl-86 antigen is present in freshly prepared rabbit thymus, spleen, and liver nuclei as well as in nuclei from various cultured cell lines, but is not detectable in extractable nuclear antigen from rabbit thymus. [ncbi.nlm.nih.gov]

However, patients who present in renal failure without hypertension or without a prior diagnosis of SSc present serious diagnostic challenges. [doi.org]

despite this, higher BP at presentation was associated with a better outcome. [qjmed.oxfordjournals.org]

• Weight Loss

  loss, pruritis Skin thickening - no or minimal progression Skin thickening - rapid progression, usually reaching peak involvement within 2 years Organs affected - Reynaud's, fingertip ulceration, oesophageal symptoms Organs affected - risk of renal [barts.wikia.com]

  Arthralgias, arthritis, and muscle weakness may occur in as many as a quarter of patients, and a small number may experience dyspnea, weight loss and dysphagia as well. [emedicine.com]

  It can also lead to tiredness, weight loss and loss of appetite. Cardiac Shortness of breath due to heart problems. [sclerodermasociety.co.uk]

  loss, vomiting, diarrhea or constipation. [rarediseases.info.nih.gov]

• Anemia

  Anemia preceded allograft SRC in two cases, pericardial effusion in one, and skin tightening in two others. [doi.org]

  Anemia may be a sign of gastric antral vascular ectasia (watermelon stomach). [aafp.org]

  Anemia: Low red blood cell counts (anemia) can contribute to many symptoms including fatigue, shortness of breath, or dizziness. This can occur because of low iron or vitamin levels, a chronic inflammatory state, or for other reasons. [hss.edu]

  GAVE can be a cause of upper gastrointestinal bleeding or iron deficiency anemia in patients with scleroderma. [en.wikipedia.org]

  It is usually heralded by sudden, severe hypertension with features of thrombotic microangiopathic hemolytic anemia. [merckmanuals.com]

• Swelling of the Finger

  There can be swelling of the fingers, hands, forearms and face and sometimes the feet and lower legs. This is followed by a skin thickening and tightness that can limit body movement. [drugs.com]

  Early in the disease, diffuse swelling of the fingers and hands ( Figure 2A ) may precede skin thickening and lead to an initial undifferentiated arthritis diagnosis. [aafp.org]

• Dyspnea

  Serial Monitoring and Outcome Measures Measurements were made at baseline and at three-month intervals throughout the study, except those made with the baseline instrument of the Mahler Dyspnea Index, which was replaced by the Mahler transitional dyspnea [doi.org]

  Arthralgias, arthritis, and muscle weakness may occur in as many as a quarter of patients, and a small number may experience dyspnea, weight loss and dysphagia as well. [emedicine.com]

  C 7, 8 Treating active interstitial lung disease with oral cyclophosphamide (Cytoxan) for one year modestly improves lung function, dyspnea, skin thickening, and health-related quality of life in patients with systemic sclerosis. [aafp.org]

  Respiratory/lungs Progressive shortness of breath (dyspnea) and pain in the chest wall (precordial chest pain) and a persistent dry cough. Renal Hypertension or the kidneys not working well. [sclerodermasociety.co.uk]

• Rales

  […] affecting the fingers ( sclerodactyly ) shiny with loss of “wrinkles” from skin folds limited mobility due to skin tightening digital ulceration edema not responsive to diuresis hyper and hypopigmentation telangiectasias on skin and mucosa respiratory dry rales [medbullets.com]

• Constipation

  There may be constipation alternating with diarrhea leading to malnutrition. [sclerodermasociety.co.uk]

  […] beginning on the fingers and face that rapidly becomes generalized; "spider veins" (telangiectasias) on the thorax, face, lips, tongue, and fingers; gastroesophageal reflux ; and difficulty eating ( dysphagia ) along with weight loss, vomiting, diarrhea or constipation [rarediseases.info.nih.gov]

  Constipation and diarrhoea may alternate. Pseudo-obstruction is treated initially by bowel rest and antibiotics. Laparotomy may be needed. Surgery may be required for rectal prolapse. [patient.co.uk]

• Diarrhea

  […] feet Pain, stiffness, and swelling of fingers and joints Wrist pain Breathing problems may result from scarring in the lungs and can include: Dry cough Shortness of breath Wheezing Digestive tract problems may include: Bloating after meals Constipation Diarrhea [medicalmarijuana.com]

  There may be constipation alternating with diarrhea leading to malnutrition. [sclerodermasociety.co.uk]

  […] fibrosis beginning on the fingers and face that rapidly becomes generalized; "spider veins" (telangiectasias) on the thorax, face, lips, tongue, and fingers; gastroesophageal reflux ; and difficulty eating ( dysphagia ) along with weight loss, vomiting, diarrhea [rarediseases.info.nih.gov]

• Dysphagia

  Symptoms include Raynaud’s phenomenon ; skin fibrosis beginning on the fingers and face that rapidly becomes generalized; "spider veins" (telangiectasias) on the thorax, face, lips, tongue, and fingers; gastroesophageal reflux ; and difficulty eating ( dysphagia [rarediseases.info.nih.gov]

  Diagnosis of SSc can be obvious in patients with combinations of classic manifestations, such as Raynaud phenomenon, dysphagia, and tight skin. [merckmanuals.com]

  Arthralgias, arthritis, and muscle weakness may occur in as many as a quarter of patients, and a small number may experience dyspnea, weight loss and dysphagia as well. [emedicine.com]

  Raynaud's (a circulation problem where fingers and toes turn white in the cold) other typical symptoms include thickening of the skin over the hands, feet and face, red spots on the skin, hard lumps under the skin, heartburn and problems swallowing ( dysphagia [nhs.uk]

  […] features Morphoea Most frequently plaque, nodular or linear More common in limited cutaneous systemic sclerosis Panniculitis Cutaneous features of systemic sclerosis Gastrointestinal symptoms Upper GIT Gastroesophageal reflux / heart burn Dyspepsia Dysphagia [dermnetnz.org]

• Abdominal Pain

  Other digestive symptoms include bloating, constipation, lower abdominal pain or difficulty controlling bowel movements. Lungs. [drugs.com]

• Xerostomia

  Flexion contracture 0001371 Malabsorption Intestinal malabsorption 0002024 Muscle weakness Muscular weakness 0001324 Osteolysis Breakdown of bone 0002797 Pulmonary fibrosis 0002206 Skin ulcer Open skin sore 0200042 Telangiectasia of the skin 0100585 Xerostomia [rarediseases.info.nih.gov]

• Hypertension

  A case of severe hypertension and acute renal failure developing in a 56 year old woman affected by diffuse scleroderma is reported. [ncbi.nlm.nih.gov]

  Abstract Scleroderma renal crisis (SRC) occurs in 5–10% of SSc patients, who may present with an abrupt onset of hypertension, acute renal failure, headaches, fevers, malaise, hypertensive retinopathy, encephalopathy and pulmonary oedema. [doi.org]

  Internal organs Routine annual screening for interstitial lung disease and pulmonary artery hypertension should include: Pulmonary function tests Transthoracic echocardiogram ECG The DETECT score is a screening tool for pulmonary artery hypertension that [dermnetnz.org]

• Chest Pain

  Respiratory/lungs Progressive shortness of breath (dyspnea) and pain in the chest wall (precordial chest pain) and a persistent dry cough. Renal Hypertension or the kidneys not working well. [sclerodermasociety.co.uk]

  Early symptoms of pulmonary hypertension include shortness of breath, chest pain, and fatigue. How common is scleroderma? Approximately 250 persons per million American adults are affected by scleroderma. [my.clevelandclinic.org]

  Patients, complain of chest pain, or dysphagia -inability to swallow. Pathologic examination of the tissue of the esophagus shows atrophy of the muscle and fibrosis of the muscle and sub mucosal layers. [arthritis.co.za]

  Problems can include chest pain, abnormal heart rhythms and heart failure. Kidneys. Kidney damage can lead to high blood pressure, headache, seizures and too little urine being made. Other symptoms. [drugs.com]

• Acrocyanosis

  Use cautiously with Raynaud's disease, chilblains, acrocyanosis, erythrocyanosis, or impaired temperature sensitivity, such as neuropathy. Use cautiously if pregnant or breastfeeding. [livingnaturallyonline.com]

• Arthritis

  Abstract We report a case of subcorneal pustular dermatosis (SPD) in a patient with rheumatoid arthritis (RA) and diffuse scleroderma. [ncbi.nlm.nih.gov]

  Arthritis Rheum 1982, 25 :241–248. PubMed CrossRef Google Scholar 11. [doi.org]

  Arthritis Res Ther. 2010, 12: R54-10.1186/ar2965. [arthritis-research.biomedcentral.com]

• Arthralgia

  Musculoskeletal Joint pain can be either arthralgia or myalgia. The terms arthralgia and myalgia are often used in combination or interchangeably. Arthralgia is defined as pain in a joint whereas myalgia is generalised muscle pain. [sclerodermasociety.co.uk]

  The Raynaud phenomenon, swelling of the extremities, and diffuse arthralgias often precede the onset... FULL TEXT [doi.org]

  Joint pain (arthralgias), muscular pain, weakness, cramps, and destruction of the tips of the fingers or toes (acroosteolysis) are frequent. [rarediseases.info.nih.gov]

  Arthralgias, arthritis, and muscle weakness may occur in as many as a quarter of patients, and a small number may experience dyspnea, weight loss and dysphagia as well. [emedicine.com]

• Tendon Friction Rub

  Palpable or audible friction rubs may be noted over the extensor and flexor tendons of the hands, knees, and ankles. [aafp.org]

  Tendon friction rubs - palpable/audible over the flexor/extensor tendons of the hands, knees and ankles. GI features GI symptoms are extremely common in SSc, occurring in the majority of cases and are often one of the earlier manifestations [ 7 ]. [patient.co.uk]

  Tendonitis is more frequent with fibrosis of the tendon sheaths, give rise to characteristic tendon friction rubs. [arthritis.co.za]

  Significance of palpable tendon friction rubs in early diffuse cutaneous systemic sclerosis. Arthritis Care Res (Hoboken). 2013 Aug. 65(8):1385-9. [Medline]. [Full Text]. Dospinescu P, Jones GT, Basu N. [emedicine.com]

• Joint Swelling

  People with diffuse scleroderma often experience: Tiredness Loss of appetite and weight Joint swelling and/or pain Skin changes, such as swelling, appearing shiny, and feeling tight and itchy. [diseases.emedtv.com]

  People with diffuse disease are often tired, lose appetite and weight, and have joint swelling or pain. Skin changes can cause the skin to swell, appear shiny, and feel tight and itchy. [sclerodermaontario.ca]

  Symptoms common with diffuse scleroderma include: Tiredness Loss of appetite or loss of weight Joint swelling Joint pain Skin can swell, appear shiny, and feel tight and itchy. The damage of diffuse scleroderma occurs over a period of a few years. [verywell.com]

• Flexion Contracture

  contracture 0001371 Malabsorption Intestinal malabsorption 0002024 Muscle weakness Muscular weakness 0001324 Osteolysis Breakdown of bone 0002797 Pulmonary fibrosis 0002206 Skin ulcer Open skin sore 0200042 Telangiectasia of the skin 0100585 Xerostomia [rarediseases.info.nih.gov]

  With disease progression, ulcerations over joints and flexion contractures of the fingers, wrists, and elbows may occur. [aafp.org]

  Flexion contractures may develop in the fingers, wrists, and elbows. Friction rubs may develop over the joints, tendon sheaths, and large bursae. Esophageal dysfunction is the most frequent visceral disturbance and occurs in most patients. [merckmanuals.com]

• Skin Disease

  METHODS: Patients enrolled in the Australian Scleroderma Cohort study with dcSSc and baseline modified Rodnan skin score (mRSS) ≥ 12 who were treated for a minimum of 12 months with MMF for the primary indication of skin disease were included and their [ncbi.nlm.nih.gov]

  […] and Musculoskeletal and Skin Diseases) [medlineplus.gov]

  A Longitudinal Biomarker for the Extent of Skin Disease in Patients with Diffuse Cutaneous Systemic Sclerosis (SSc). Skin gene expression can be used effectively to monitor SSc skin disease change over time. PubMed, Arthritis Rheumatol, 08/03/2015. [sclero.org]

  Of these 6 completers, 4 were found to have full resolution of their skin disease and 3 were found to be free of all disease activity in the final physician and patient assessments. [roadback.org]

• Localized Scleroderma

  Localized Scleroderma The changes, which occur in localized scleroderma, are usually found in only a few places on the skin or muscles, and rarely spread elsewhere. Generally, localized scleroderma is relatively mild. [scleroderma.org]

  Localized Scleroderma Localized types of scleroderma affect the skin and related tissues, and sometimes the muscle below. Internal organs are not affected. Localized scleroderma can never progress to the systemic type of the disease. [verywell.com]

  Treatment of Localized Scleroderma There is no one treatment for localized scleroderma. [center4research.org]

  The two main types are systemic scleroderma and localized scleroderma. The milder forms are most often seen in women between the ages of 30 and 50; the more severe forms usually affect men, blacks, and older persons. [medical-dictionary.thefreedictionary.com]

• Skin Ulcer

  ulcer Open skin sore 0200042 Telangiectasia of the skin 0100585 Xerostomia Dry mouth Dry mouth syndrome Reduced salivation [ more ] 0000217 5%-29% of people have these symptoms Abnormal bowel sounds 0030142 Congestive heart failure Cardiac failure Cardiac [rarediseases.info.nih.gov]

  (rigidity) Tight, mask-like facial skin Ulcerations on the fingertips and toes Pain and stiffness in the joints Persistent cough Shortness of breath Heartburn ( acid reflux ) Difficulty swallowing Digestive and gastrointestinal problems Constipation Weight [my.clevelandclinic.org]

  There also can be: Skin ulcers Skin that is lighter or darker than usual Loss of hair Abnormal skin dryness, including vaginal dryness Calcium deposits in the skin (subcutaneous calcinosis) Small red spots caused by localized swelling of tiny blood vessels [drugs.com]

  Oral sildenafil in skin ulcers secondary to systemic sclerosis. Scand J Rheumatol. 2011. 40(4):323-5. [Medline]. Hummers LK, Wigley FM. Management of Raynaud's phenomenon and digital ischemic lesions in scleroderma. [emedicine.com]

• Fingertip Ulceration

  Constitutional symptoms - fatigue common Constitutional symptoms - fatigue, weight loss, pruritis Skin thickening - no or minimal progression Skin thickening - rapid progression, usually reaching peak involvement within 2 years Organs affected - Reynaud's, fingertip [barts.wikia.com]

  It also results in skin color changes in the fingers and toes Acid reflux Hair loss Irregular pigmentation of skin Joint pain and painful joint movement, pain in the feet Ulcer formation on the fingertips or toes Difficulty breathing and swallowing, dry [dovemed.com]

  […] at the fingertips. [mollysfund.org]

  Low-dose aspirin is often added to prevent tiny blood clots in the fingers, especially in patients with a history of fingertip ulcerations. [medicinenet.com]

• Pruritus

  Skin can breakdown and discharge chalky material (calcium) Salt and pepper dyspigmentation ( hyperpigmentation and hypopigmentation ) Pruritus Rarer cutaneous features Morphoea Most frequently plaque, nodular or linear More common in limited cutaneous [dermnetnz.org]

  […] scleroderma is rapidly progressive involvement of pulmonary, renal, or cardiac systems indicate a more severe prognosis one of the highest mortalities among systemic autoimmune diseases limited scleroderma is more benign Presentation Symptoms skin diffuse pruritus [medbullets.com]

  […] eyes Improve dry mouth Improve dry mouth and dry eyes Reactive depression Selective serotonin reuptake inhibitors Tricyclic antidepressants Improve symptoms of depression and peripheral pain Improve symptoms of depression, may improve restorative sleep Pruritus [fortherecordmag.com]

  Abnormal funduscopy examination findings Hypertension Schistocytes on peripheral smear Skin Calcinosis Calcium deposits along extensor tendons and on digits Hyper- or hypopigmentation Tanned skin on sun-exposed and unexposed areas or loss of pigmentation Pruritus [aafp.org]

• Facial Pain

  Neurologic/psychiatric Facial pain and decreased sensation. Pins and needles sensation (paresthesias) and weakness in the hand. Headaches, depression, and anxiety. It can also lead to tiredness, weight loss and loss of appetite. [sclerodermasociety.co.uk]

  Other symptoms can include dry eyes and mouth, sudden episodes of severe facial pain (trigeminal neuralgia), and impotence. [drugs.com]

  Other: facial pain due to trigeminal neuralgia, hand paresthesias, headache, stroke, fatigue, calcinosis and weight loss. [en.wikipedia.org]

• Peripheral Neuropathy

  Peripheral neuropathy: a complication of systemic sclerosis. Clin Rheumatol. 2013 Jun. 32(6):885-8. [Medline]. Tyndall A, Fistarol S. The differential diagnosis of systemic sclerosis. Curr Opin Rheumatol. 2013 Nov. 25(6):692-9. [Medline]. [emedicine.com]

• Kidney Failure

  Heart failure Scarring of the lungs, called pulmonary fibrosis High blood pressure in the lungs (pulmonary hypertension) Kidney failure (scleroderma renal crisis) Problems absorbing nutrients from food Cancer Call your provider if you develop Raynaud [nlm.nih.gov]

  Kidney problems may lead to high blood pressure and, if untreated, kidney failure. Lung damage is the leading cause of death with this condition. In rare cases, systemic sclerosis may involve internal organs but not the skin. [arthritis.org]

  Not only can it affect the skin, but it also can affect many internal organs, hindering digestive and respiratory functions, and causing kidney failure. Systemic scleroderma can sometimes become serious and life-threatening. [my.clevelandclinic.org]

  Common complications include: Bleeding Pulmonary hypertension Heart rhythm problems Heart failure Kidney failure High blood pressure Diagnosis The doctor will ask about your symptoms and medical history. A physical exam will be done. [uvahealth.com]

  More-serious effects of kidney complications may include renal crisis, which involves a sudden increase in blood pressure and rapid kidney failure. Heart. [mayoclinic.org]

Sclerodera Workup. Medscape. Available online at http://emedicine.medscape.com/article/331864-workup. Accessed September 2013. Scleroderma: An Overview. Cleveland Clinic. [labtestsonline.it]

Her physician sends her for additional autoimmune workup. [medbullets.com]

"Scleroderma Workup". Medscape Reference. WebMD. Archived from the original on 6 March 2014. Retrieved 6 March 2014. ^ a b c d e f g Jimenez, SA; Cronin, PM; Koenig, AS; O'Brien, MS; Castro, SV (15 February 2012). [en.wikipedia.org]

Diagnosis is based on clinical manifestations, but tests and procedures may be used initiallly to exclude alternative diagnoses, and later for assessment of organ involvement and monitoring of disease progression (see Presentation and Workup ). [emedicine.com]

• Pericardial Effusion

  Anemia preceded allograft SRC in two cases, pericardial effusion in one, and skin tightening in two others. [doi.org]

  Cardiac involvement in systemic sclerosis includes myocardial disease, conduction system defects, arrhythmias, or pericardial disease. [aafp.org]

  Pericarditis or pericardial effusion ; these may cause cardiac impairment or congestive cardiac failure. Arrhythmias and conduction defects (including bradyarrhythmias and tachyarrhythmias). Endocarditis. [patient.co.uk]

• Esophageal Motility Disorder

  Murthy, SECONDARY ESOPHAGEAL MOTOR DISORDERS, Pearson's Thoracic and Esophageal Surgery, 10.1016/B978-0-443-06861-4.50218-5, (725-730), (2008). Ellen C. [doi.org]

• Soft Tissue Calcification

  Scleroderma, also known as systemic sclerosis, is an autoimmune connective tissue disorder characterized by multisystem fibrosis and soft tissue calcification. [radiopaedia.org]

• Myocardial Fibrosis

  […] systemic sclerosis is heart failure due to dilated cardiomyopathy, likely related to pulmonary hypertension and myocardial fibrosis. [emedicine.com]

  Interstitial and peribronchial fibrosis or intimal hyperplasia of small pulmonary arteries can develop; if long-standing, pulmonary hypertension can result. Diffuse myocardial fibrosis or cardiac conduction abnormalities occur. [merckmanuals.com]

  Potential cardiac problems due to SSc include [ 11, 12 ] : Microvascular coronary artery disease (resulting in myocardial ischaemia). Accelerated atherosclerosis with subsequent coronary heart disease. Myocardial fibrosis. [patient.co.uk]

Among patients with early diffuse cutaneous systemic sclerosis, HSCT was associated with increased treatment-related mortality in the first year after treatment. [ncbi.nlm.nih.gov]

Seventy-five patients in each group started treatment. Six patients did not receive the allocated treatment, whereas 71 (89.8%) and 57 (74.0%) completed treatment in the HSCT and cyclophosphamide groups, respectively ( Figure 1 ). [doi.org]

All three, in contrast to the first published study, in which a single treatment course failed to induce a marked effect on skin thickening [ 2 ], involved either optional or preplanned repeat treatment. [arthritis-research.biomedcentral.com]

There are lots of questions re prognosis life expectancy etc going round in my head right now. my arms legs mouth are affected currently and my upper chest is just beginning to feel taut (3 days now) i have some acid reflux but that is it. would like [healthunlocked.com]

In patients presenting with early diffuse scleroderma prognosis is variable. Our goal was to determine possible baseline predictors of future good outcomes. [ncbi.nlm.nih.gov]

Treatment and prognosis No cure for scleroderma exists. Treatment aims to reduce systemic involvement and target particular symptomatic organ systems. [radiopaedia.org]

Prognosis The disease course varies with each individual. The prognosis depends on the extent of complications. Therefore, mortality figures vary enormously. Overall, five-year survival is around 75% and ten-year survival is around 62.5% [ 24 ]. [patient.co.uk]

CONCLUSION: Patients with diffuse scleroderma without renal crisis rarely have significant increases in serum creatinine or proteinuria that cannot be explained by other etiologies. [ncbi.nlm.nih.gov]

Etiology and pathogenesis of scleroderma. In: Firestein GS, Budd RC, Gabriel SE, McInnes IB, O'Dell JR, eds. Kelley and Firestein's Textbook of Rheumatology. 10th ed. Philadelphia, PA: Elsevier; 2017:chap 83. Varga J. [nlm.nih.gov]

[…] blue (hypoxia) to red (re-perfusion) E sophageal dysmotility S clerodactyly T elangiectasia Epidemiology demographics female > male African Americans > Caucasian 30-50 years of age but can affect all ages risk factors exposure to potential triggers Etiology [medbullets.com]

Scleroderma's etiology is unknown, although previous studies have provided a few hints. [nature.com]

Jørn Olsen and Olga Basso, Reproductive Epidemiology, Handbook of Epidemiology, 10.1007/978-3-540-26577-1_27, (1043-1109), (2005). [doi.org]

[…] blood flow to skin from either cold temperatures or stress, which causes vasospasms colors of affected area, commonly the digits, change from white (ischemia) to blue (hypoxia) to red (re-perfusion) E sophageal dysmotility S clerodactyly T elangiectasia Epidemiology [medbullets.com]

"Epidemiology of systemic sclerosis: incidence, prevalence, survival, risk factors, malignancy, and environmental triggers". Current Opinion in Rheumatology. 24 (2): 165–70. doi : 10.1097/BOR.0b013e32834ff2e8. [en.wikipedia.org]

Linked Articles Clinical and epidemiological research Britta Maurer Nicole Graf Suzana Jordan Carina Mihai Otylia Kowal-Bielecka Yannick Allanore Oliver Distler on behalf of EUSTAR coauthors Marco Matucci Cerinic Serena Guiducci Ulrich Walker Giovanni [ard.bmj.com]

Tyrosine kinases are involved in transforming growth factor-beta and platelet-derived growth factor, which play a central role in the pathophysiology of systemic sclerosis. [medlink.com]

Z CHEN, Systematic review: pathophysiology and management of gastrointestinal dysmotility in systemic sclerosis (scleroderma), Alimentary Pharmacology & Therapeutics, 23, 6, (691-712), (2006). I. MARIE, P. DUCROTTE, P. DENIS, M. F. HELLOT and H. [doi.org]

Endothelin signalling is implicated in the pathophysiology of fibrosis. [22] Vitamin D is implicated in the pathophysiology of the disease. [en.wikipedia.org]

This report emphasizes the possibility that the correction of malignant hypertension may prevent progressive renal falure in some patients affected by diffuse scleroderma. [ncbi.nlm.nih.gov]

How can Diffuse Systemic Scleroderma be Prevented? Currently, there are no specific methods or guidelines to prevent Diffuse Systemic Scleroderma. [dovemed.com]

[…] subset of patients with diffuse cutaneous systemic sclerosis (defined as widespread skin involvement) and internal organ involvement and has a mortality of 30% to 50% at 5 years. 1 Conventional-dose immunosuppressive therapy has limited efficacy in preventing [doi.org]

[…] of Raynaud's Phenomenon Unknown status NCT00577304 Phase 3 Nitroglycerin;Topical AmphiMatrix 22 Study of a Topical Formulation for the Treatment and Prevention of Raynaud's Phenomenon Symptoms Unknown status NCT00934427 Phase 3 0.9% nitroglycerin in [malacards.org]