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Lastly, it is important to remark that ED could represent an early predictor of CV events and the diagnosis of vasculogenic ED at PDU, and particularly at dynamic PDU as the gold standard diagnostic tool, both in patients with or without additional CV risk factors and/or comorbidities, can help to recognize eventual arterial diseases in biggest distal vessels [35, 39,40,41]

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Nausea, if it occurs, tends to be mild and manageable during this phase

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These observations underscore the involvement of the hypoxic microenvironment in MS-associated vascular pathology, implying that strategies aimed at improving vascular oxygenation, mitigating immunoinflammatory damage, downregulating vasoactive substances, and reversing vascular abnormalities may reduce ischemic damage to the skin and visceral organs