Résumé
This work comprises the study of the effect of Nifedpine versus Captopril on peripheral arterial changes in systemic sclerosis [SS]. Eight patients presenting with systemic sclerosis were subjected to complete clinical evaluation, photoplethysmography at room temperature, after cold exposure and after heat exposure, arterial doppler of both upper and lower limbs and Duplex examination of digital arteries. These tests were applied on the patients basically before and after two hours of oral intake of 20mg Nifedipine [these represent group A]. The same tests were applied on the same patients after intake of captopril 25mg t.d.s for one week [these represent group B]. There was a sufficient gap of time between both groups to ensure the washout of Nifedipine. Photoplethysmographic study of the hands basically, showed that six patients out of the eight were vasospastic, while the remaining two cases had organic lesions. Group A [after Nifedipine]: Nifedipine reversed the waveform abnormalities in six cases of vasospasm, but with no effect on the two patients with organic lesions. Group B [after Captopril]: Plethysmographic studies showed no significant improvement neither in amplitude of arterial waveform nor in its contour. We conclude from this study that Nifedipine can be helpful in improving the digital blood flow and reducing the peripheral vascular resistance in cases presenting with SS with Raynaud's phenomenon and that these results are valuable in the vasospastic types. On the other hand, the results of captopril therapy were not encouraging for the management of Raynaud's phenomenon