Abstract
We presented two cases of diffuse cutaneous type of systemic sclerosis with multiple ulcers and gangrenous lesions on the feet and toes. The first case, a 46-year-old woman, presented with ulcers and purpura on her foot. When her ulcers worsened, elevated MPO-ANCA levels were noted. As renal dysfunction developed after her admission, predonisolone (PSL), 40mg/day, was orally administered under the diagnosis of ANCA-related nephritis. Although her renal function improved with the treatment, all her digits turned to be gangrenous. The second case, a 44-year-old woman, presented ulcers and gangrenous lesions on her feet and toes. Elevated MPO-ANCA levels were also noted. The treatment with oral PSL, 30mg/day, was started for deteriorating interstitial pneumonia. Arteriographic examination of the lower extremities showed stenosis and occlusion of plantar digital arteries, plantar artery and posterior tibial artery. In both patients, functional loss was minimized with conservative treatments.
