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  • WHAT: Digital ulcers/scars. Digital Ulceration: painful, recurrent depressed skin lesions, usually involving the fingertips in which both the epidermis and the dermis are absent. Digital scars are stellate shaped scars of old ulcers also located at the tips of the fingers. WHY: These digital ulcers and scars occur in scleroderma. HOW: The ulcers are 5 to 10 mm in diameter and usually involve the finger- tips. The ulcers appear as shallow pits with sloped edges. They have a bland appearance, in contrast to the punched out or dark, necrotic lesions of the digits seen in polyarteritis. These benign appearing ulcers are painful, heal slowly, and tend to be recurrent. They are often adjacent to star-shaped scars which represent old healed ulcers. REFS: Tuffanelli, DL and Winkelmann, RK: Systemic scleroderma: clinical study of 727 cases. Arch Dermatol 84:359, 1961. DN19305-4.
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