Adoue D, Arlet P, Vilain C, Le Tallec Y, Bonafé J L, de Lafontan B
Ann Dermatol Venereol. 1985;112(2):151-5.
Raynaud's phenomenon is studied in three patients after cancer chemotherapy. In these cases, Raynaud's phenomenon occurs as: a true coincidence, a secondary complication of which neoplastic biological signs are thrombocythemia, hyperfibrinemia, immune complexes, cryoglobulinemia..., a therapeutic implication. The rate of therapeutic implication is difficult to precise. Raynaud's phenomenon is a little symptom over a severe illness. Several drugs are responsible for this fact. A literature review mentions Vincristine, Bleomycin, Cisplatin... For our three patients as in the literature review the tumoral nature is less important than the drug type. For us Bleomycin alone as in association is able to induce Raynaud's phenomenon. The occurrence of single Raynaud's phenomenon may be a systemic scleroderma is first sign. However it is important to affirm the true single Raynaud's phenomenon. In this case there is a lack of signs: scleroderma may be paraneoplastic, drugs may be pulmonary toxic, anticentromere antibodies may be positive during antineoplastic treatment. The pathogenesis for Raynaud phenomenon drug induction is unknown. For Bleomycin action the role of skin concentration, fibroblastic lesion, and vascular disturbance is discussed.
对3例癌症化疗后的患者进行了雷诺现象的研究。在这些病例中，雷诺现象的发生情况如下：一种真正的巧合、一种继发并发症，其肿瘤生物学体征包括血小板增多症、高纤维蛋白血症、免疫复合物、冷球蛋白血症……以及一种治疗影响。治疗影响的发生率难以精确确定。雷诺现象在严重疾病中是一个轻微症状。有几种药物会导致这种情况。文献综述提到长春新碱、博来霉素、顺铂……对于我们的3例患者以及文献综述中的情况，肿瘤性质不如药物类型重要。对我们而言，单独使用博来霉素或联合使用博来霉素都能够诱发雷诺现象。单纯性雷诺现象的出现可能是系统性硬化症的首发症状。然而，确认真正的单纯性雷诺现象很重要。在这种情况下，存在一些体征缺失：硬皮病可能是副肿瘤性的，药物可能具有肺毒性，在抗肿瘤治疗期间抗着丝点抗体可能呈阳性。药物诱发雷诺现象的发病机制尚不清楚。对于博来霉素的作用，讨论了皮肤浓度、成纤维细胞损伤和血管紊乱的作用。
