TREATMENT OF VASCULITIC LEG ULCERS IN CONNECTIVE-TISSUE DISEASE WITH ILOPROST

Leg ulcers are a recognised manifestation of cutaneous vasculitis in c onnective tissue diseases (CTDs) including rheumatoid arthritis (RA). Iloprost a stable prostacyclin analogue has been successfully used to treat Raynaud's phenomenon and digital ulcers associated with CTD's. O ur aim was to assess iloprost in the treatment of vasculitic leg ulcer s in CTD. In this paper we describe eight cases of vasculitic leg ulce ration in association with RA and CTD, treated with intravenous ilopro st. The iloprost was administered for 6-8 hours daily and continued fo r 21-28 days. Immunosuppressive therapy was required in three patients with severe necrotising vasculitis (RAnv). Complete ulcer healing was achieved in four patients within 6 weeks of commencing therapy while rapid improvement occurred in the other four patients. This suggests t hat iloprost may be useful as an adjunct to therapy for vasculitic leg ulcers. A double-blind placebo controlled study of iloprost therapy f or Ri leg ulcers is under way.