Botulinum Toxin Type A: A Treatment Option for Digital Ischemia in Patients With Raynaud's Phenomenon

Fregene, Alero; Ditmars, Donald M.; Siddiqui, Aamir

doi:10.1016/j.jhsa.2008.11.026

Cited by 122 publications

(154 citation statements)

References 14 publications

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“…The injection of BTX A into the perineurovascular tissue of the wrist or digit, blocks sympathetic nerve conduction and reduces vasospasm, thus significantly improves the healing process of digital ulcers [16,17].…”

Section: Resultsmentioning

confidence: 99%

Successful Intensification of Intravenous Rheological Treatment of Phalanges Ischemia in SSc Patient Using Alprostadil

Walecka¹,

Malewska²,

Lagun³

et al. 2017

J Cardiovasc Dis Diagn

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Systemic sclerosis (SSc) is a rare, auto immunological, connective tissue disease characterized by vasomotor disturbances, fibrosis and further atrophy of the skin and internal organs. There are many factors leading to immunological and vascular changes. One of the most prominent vascular symptoms is Raynaud's phenomenon, which may be caused by different factors such as cold or excessive stress. This case report presents a 37-year old Caucasian woman with SSc, with severely impaired microcirculation of the hands and necrosis of the distal phalanges due to several hours of exposure to the cold. The patient required intensification of intravenous rheological treatment with alprostadil and oral usage of sildenafil, which had a positive effect on the improvement of the impaired microcirculation. Like many others, this case demonstrates that IV. rheological treatment may be effective in restoring microcirculation in such cases among SSc patients.

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Section: Resultsmentioning

confidence: 99%

Successful Intensification of Intravenous Rheological Treatment of Phalanges Ischemia in SSc Patient Using Alprostadil

Walecka¹,

Malewska²,

Lagun³

et al. 2017

J Cardiovasc Dis Diagn

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“…Surgical therapy includes arterial bypass, digital arterial reconstruction, sympathectomy (peripheral and digital) and amputation [12][13][14][15]. Recently botulinum toxin injection and local or intramuscular injection of mesenchymal stem cell have been used in the management of patients with digital ischemia due to secondary RP [16][17][18]. An endovascular procedure, as we present in our case, has not been reported previously in the management of RP.…”

Section: Discussionmentioning

confidence: 99%

Endovascular Revascularization in Secondary Raynaud’s Phenomenon

Egmond

2013

J Med Cases

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Endovascular intervention is not previously described in patients with exacerbated Raynaud's phenomenon (RP). A 45-year-old male with secondary RP and CREST (Calcinosis cutis, Raynaud's phenomenon, Esophageal dysmotility, Sclerodactyly and Telangiectasia) with a smoking history, who was noncompliant in the noninterventional treatment, presented with necrosis of the right hand in exacerbated RP. An intra-arterial digital subtraction angiography (DSA) showed occlusion of the right distal ulnar and radial arteries. Initial pharmacological therapy showed no improvement. Thrombolysis with Urokinase therapy had a beneficial, but not optimal, effect on perfusion. This was probably due to an atherosclerotic component. An endovascular intervention, 2 mm balloon dilatation, in the right radial artery; improved this significantly. The clinical situation proved stable and no expansion of necrosis was seen. An endovascular procedure, not previously described in RP management, can be helpful in the treatment of exacerbated RP; especially when an atherosclerotic component is present.

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“…All but 5 patients experienced improved vascularity and relief of pain Neumeister et al (2009) 19 pts 84% reported pain reduction at rest and improvement of the perfusion and ulcerations Fregene et al (2009) 26 pts Statistically significant improvements were noted for pain score and digit transcutaneous oxygen saturation Van Beek et al (2007) 11 patients All patients reported highly significant pain reduction and 9 pts with ulcers spontaneously healed Kossintseva (2008) One patient The BT-A treated hand had reduced swelling, color change, and pain, whereas the untreated control hand remained affected Jenkins (2013) 10 pts randomized controlled study…”

Section: Studymentioning

confidence: 96%

“…Most of these studies are case series (Liu, 2006;Heckmann et al, 2002;Kossintseva et al, 2011;Iorio et al, 2012;Serri et al, 2013) , one is randomized controlled trial (Neumeister, 2010) and two case reports (Neumeister et al, 2009;Fregene et al, 2009) (Table 3). In all of these studies the patients were presented with chronic ischemic hand pain, ulceration and loss of function.…”

Section: Raynaud Syndromementioning

confidence: 99%

Botulinum toxin: Non cosmetic and off-label dermatological uses

Alghamdi

Alghanemy

Joharji

et al. 2015

Journal of Dermatology & Dermatologic Surgery

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Botulinum toxin (BT-A) is a neurotoxin which is produced by the Gram-positive anaerobic bacterium Clostridium botulinum. The efficacy of Botulinum toxin in treating hyperhidrosis and the glabellar lines is well known and FDA approved.Because BT-A inhibits the release of acetylcholine and many other neurotransmitters such as norepinephrine and substance P at the level of nerve ending, this toxin has been used to treat a lot of dermatological disorders which are thought to be triggered by these neurotransmitters.In this article we are discussing the medical off-label uses of BT-A in dermatology.ª 2014 Production and hosting by Elsevier B.V. on behalf of King Saud University.

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Botulinum Toxin Type A: A Treatment Option for Digital Ischemia in Patients With Raynaud's Phenomenon

Cited by 122 publications

References 14 publications

Successful Intensification of Intravenous Rheological Treatment of Phalanges Ischemia in SSc Patient Using Alprostadil

Successful Intensification of Intravenous Rheological Treatment of Phalanges Ischemia in SSc Patient Using Alprostadil

Endovascular Revascularization in Secondary Raynaud’s Phenomenon

Botulinum toxin: Non cosmetic and off-label dermatological uses

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