Ischemic ulcers of the toes secondary to Raynaud’s phenomenon in a child successfully treated with botulinum toxin

Quintana‐Castanedo, Lucía; Feito-Rodríguez, M.; Pedrero, Rocío Maseda; Fernández, Cristina Gómez; Laguna, Raúl de Lucas

doi:10.1111/pde.14160

Cited by 3 publications

(12 citation statements)

References 9 publications

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“…9,15,25,26,43,44 There were 7 case series', including a range of 2 to 11 patients. 4,20,28,31,[35][36][37] There were 15 single case reports, 1,2,5,10,14,17,21,23,24,27,29,32,33,40,46 1 piece of original research, 38 and 1 clinical trial. 45 The largest study was a randomized trial by Motegi et al 26 in 2017, which included 45 patients.…”

Section: Resultsmentioning

confidence: 99%

“…Overall, outcomes were positive in 96.2% (409 of 425) of patients. Of the 22 studies 9,11,16,[18][19][20]22,[24][25][26][29][30][31]34,[37][38][39]41,[43][44][45][46] that included the visual analog scale (VAS) or another pain scale, 95.5% (21 of 22) showed trends of decreasing pain after BT injections, whereas the remaining study did not report a trend. There were 36.4% of these (8 of 22) that were statistically significant, 18.2% (4 of 22) were not statistically significant, 45.5% (9 of 22) did not report statistical significance for this data.…”

Section: Positive Resultsmentioning

confidence: 99%

“…Fifty percent (21 of 42) of studies used healing of digital ulcers as an outcome measure. 4,[11][12][13][14]16,18,19,22,23,[25][26][27]30,31,36,38,42,43,45,46 Two of these were randomized trials by Du 43 and Bello 25 that showed no statistically significant difference in healing compared with placebo. However, Du only injected 20 U BT per hand, a lower dose than the other studies.…”

Section: Positive Resultsmentioning

confidence: 99%

“…Three of 42 studies used the McCabe cold sensitivity score. 25,44,46 This is a patient questionnaire that assesses the severity of cold sensitivity in the hands, as well as the exposure of the hands to cold on a daily basis. 48 A case report by Quintana-Castanedo 46 found a decrease in 5 points on the McCabe Cold score after BT injection, showing improvement in cold tolerance.…”

Section: Positive Resultsmentioning

confidence: 99%

“…25,44,46 This is a patient questionnaire that assesses the severity of cold sensitivity in the hands, as well as the exposure of the hands to cold on a daily basis. 48 A case report by Quintana-Castanedo 46 found a decrease in 5 points on the McCabe Cold score after BT injection, showing improvement in cold tolerance. A randomized controlled trial by Seyedmardani et al 44 found a statistically significant improvement in McCabe cold sensitivity score after BT injection compared with control at 2 months.…”

Section: Positive Resultsmentioning

confidence: 99%

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The Use of Botulinum Toxin in Raynaud Phenomenon

2023

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Background Raynaud phenomenon (RP) is a vasospastic condition of the digits that can be primary or secondary to systemic disease. Symptoms are triggered by cold or stress and can cause pain and skin color changes. The chronic ischemia may lead to necrosis, ulceration, and amputation. There are no Food and Drug Administration–approved treatments and cases refractory to pharmacologic and surgical treatments are difficult to control. Local botulinum toxin injections have been increasingly used in the treatment of Raynaud disease and have shown promising results. Aim of the study To examine the outcomes, techniques, and complications of botulinum toxin use for the treatment of Raynaud disease. Methods The PubMed database was queried using “botulinum toxin” AND “Raynaud phenomenon” as title key words. Preferred reporting items for systematic reviews and meta-analysis criteria were used. Additional articles were selected while reviewing the references of the articles from PubMed. No time restrictions were followed. Articles of all languages were included. Articles were analyzed for study type, demographics, diagnosis/inclusion criteria, treatment methods, outcome measures, length of follow-up, results, and complications. A positive outcome was defined as subjective improvement in symptoms and/or improvement in the outcome measures. A poor outcome was defined as harm done to the patient by the injection that would not have occurred otherwise. Results Forty-two clinical studies describing the use of botulinum toxin for Raynaud's phenomenon were found. A total of 425 patients with primary or secondary Raynaud's were treated, with ages ranging from 14 to 91 years. There were 342 women and 81 men, with a female-to-male ratio of 38:9. Outcomes were positive in 96.2% of patients. There were 14.2% of the studies that reported 3.5% of all patients showing no subjective improvement. A single study reported a poor outcome for 1 patient. There were 40.5% of the studies that reported complications, affecting 20.2% of all patients. The most frequently reported complication was transient hand weakness, affecting 44.2% of patients with complications and 8.9% of total patients. Weakness resolved in hours to months after injection. Pain at the injection site lasting minutes to days was reported in 40.7% of patients with complications, and 8.2% of total patients. Conclusions Botulinum toxin treatment for RP is effective. Complications are minor and self-limiting.

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Section: Resultsmentioning

confidence: 99%

Section: Positive Resultsmentioning

confidence: 99%

Section: Positive Resultsmentioning

confidence: 99%

Section: Positive Resultsmentioning

confidence: 99%

Section: Positive Resultsmentioning

confidence: 99%

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The Use of Botulinum Toxin in Raynaud Phenomenon

2023

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Raynaud’s Phenomenon in the Pediatric Age

Zulian,

Pain

2024

Raynaud’s Phenomenon

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Botulinum Toxin Type A for the Treatment of Skin Ulcers: A Review Article

Winayanuwattikun

Vachiramon

2022

Toxins

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The normal biological wound healing process consists of three precisely and highly programmed phases that require optimal conditions including internal and external factors. Any negative factors that disrupt the sequence or time frame of the healing mechanism can result in a non-healing wound or chronic ulcers. Botulinum neurotoxin A (BoNT-A) which is generally known as anti-contraction of muscles has been reported as a successful treatment in various types of chronic ulcers. The aim of this study is to review the outcome of treatment with BoNT-A for chronic skin ulcers. The results demonstrated some positive effects of BoNT-A on chronic ulcers. Ischemic ulcers secondary to Raynaud’s phenomenon seem to be the most promising type of ulcers that have benefited from BoNT-A. The rationale behind using BoNT-A to fasten the wound healing process is also discussed. Further clinical trial studies should be conducted to affirm the efficacy of wound healing using BoNT-A administration.

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Ischemic ulcers of the toes secondary to Raynaud’s phenomenon in a child successfully treated with botulinum toxin

Cited by 3 publications

References 9 publications

The Use of Botulinum Toxin in Raynaud Phenomenon

The Use of Botulinum Toxin in Raynaud Phenomenon

Raynaud’s Phenomenon in the Pediatric Age

Botulinum Toxin Type A for the Treatment of Skin Ulcers: A Review Article

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