Topical Cannabidiol in the Treatment of Digital Ulcers in Patients with Scleroderma: Comparative Analysis and Literature Review

Advances in Skin & Wound Care
Open Access

Clinical Summary

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What was studied

Adults with systemic sclerosis and painful digital ulcers were assigned to topical cannabidiol (CBD) during debridement (n=25) or standard local therapy (n=20), with pain (NRS), HAQ-DI, sleep, analgesic use, and healing assessed from baseline to about 1 month.

Key findings

At ~1 month, CBD led to larger pain reductions (background NRS 8.4→6.0 vs 8.44→7.88; P<.0001 between groups), reduced incident pain (9.32→6.8 vs stable; P<.0001), more sleep (2.56→5.67 h vs 2.65→3.25 h), less additional analgesic use (12/25 [48%] vs 20/20 [100%]), and higher complete healing (18/25 [72%] vs 6/20 [30%]); HAQ-DI improved in the CBD group (2.19→0.79), and adverse events were mild (itch/erythema in 7/25) with no severe events.

Study limitations

Open-label design with unclear randomization details and short follow-up (~1 month); single-center, small sample; protocol reporting inconsistencies (e.g., mention of oral CBD and 2-month follow-up vs 1-month outcomes).

Clinical implications

Topical CBD was associated with less wound-related and incident pain, better sleep, and more healed ulcers at ~1 month, with only mild local reactions. Treat these results as preliminary and await larger, blinded randomized trials before changing routine practice.