Treatment of refractory ischemic skin ulcers in patients with Raynaud's phenomenon with PGE₁ infusions

Prostaglandin E₁ (PGE₁) is a potent vasodilator and inhibitor of platelet aggregation. We administered 20 PGE₁ infusions to 12 patients with severe Raynaud's phenomenon, associated with refractory ischemic skin ulcers. There was symptomatic improvement following 17 of the 20 infusions, while 35 of the 65 ischemic ulcers healed between 2-6 weeks following treatment. The benficial effects persisted for between 1-18 months. While the treatment was well-tolerated in most patients, the procedure is not without risks. On the basis of this retrospective study, a trial of PGE₁ infusion is recommended in the treatment of patients with ischemic skin ulcers, which have been refractory to other treatment modalities.