• Male or female patient ≥18 years of age,

• Patient with systemic sclerosis according to the 2013 ACR/EULAR classification criteria9,

• SSc patient with at least one refractory active ischemic digital ulcer at inclusion visit (see below the eligibility conditions of a DU),

• Age \> 50 years and not treated with any kind of hormone replacement therapy for at least 2 years prior to screening, with amenorrhea for at least 24 consecutive months prior to screening. An assessment of serum follicle stimulating hormone showing a level of \> 40 TU/L at screening may be used to exclude childbearing potential, based on the discretion of the investigator,

• Patient must have provided written informed consent prior to enrolment,

• Patient must be able to understand their requirements of participating in the protocol,

• Patient affiliated to a social security system.

• Relative to each DU :

‣ The DU at inclusion visit must show all the following characteristics:

⁃ Located beyond the proximal interphalangeal joint, on finger surface (included periungual ulcers),

⁃ Of ischemic origin according to the physician,

⁃ Not over subcutaneous calcifications or bone relief,

⁃ Active DU,

⁃ Refractory after 10±2 weeks of standard of care according to EULAR recommendations26 (that is either still active (chronic) or new occurrence despite standard of care)