Jiménez-Gallo David, Albarrán-Planelles Cristina, Arjona-Aguilera Cintia, Blanco-Sánchez German, Rodríguez-Mateos María Eugenia, Linares-Barrios Mario
Department of Dermatology, Hospital Universitario Puerta del Mar, Cadiz, Spain.
Department of Pharmacy, Hospital Universitario Puerta del Mar, Cadiz, Spain.
Dermatol Ther. 2015 May-Jun;28(3):135-9. doi: 10.1111/dth.12207. Epub 2015 Feb 3.
Thromboangiitis obliterans (TAO) or Buerger's disease is a vascular inflammatory thrombotic occlusive and segmental disease affecting distal small and medium-sized arteries of the limbs. Tobacco is the main trigger factor and avoiding it is the main treatment. Frequently, it is necessary to use high-potency vasodilators, such as iloprost, bosentan, sildenafil, or alprostadil, to relieve symptoms and reduce the risk of amputation. Iloprost is the only one that has been shown to be effective in randomized clinical trials. We report the third case of TAO treated with sildenafil and a new case treated with bosentan. This condition can be diagnosed and treated by a dermatologist. We would like to highlight the excellent clinical response despite the fact that patients continued to smoke. This finding may have important therapeutic implications because early treatment may prevent amputation and can be effective even during the process of giving up smoking.
血栓闭塞性脉管炎（TAO）或伯格氏病是一种血管炎性血栓闭塞性节段性疾病，影响四肢远端中小动脉。烟草是主要触发因素，避免吸烟是主要治疗方法。通常，有必要使用强效血管扩张剂，如伊洛前列素、波生坦、西地那非或前列地尔，以缓解症状并降低截肢风险。伊洛前列素是唯一在随机临床试验中被证明有效的药物。我们报告了第三例用西地那非治疗的TAO病例和一例用波生坦治疗的新病例。这种疾病可由皮肤科医生诊断和治疗。我们想强调的是，尽管患者继续吸烟，但仍有出色的临床反应。这一发现可能具有重要的治疗意义，因为早期治疗可能预防截肢，甚至在戒烟过程中也可能有效。
