12365 Division of Dermatology, Department of Medicine, University of Ottawa and the Ottawa Hospital, Ottawa, Ontario, Canada.
Faculty of Medicine, University of Ottawa, 451 Smyth Road, K1H 8L1, Ottawa, Ontario, Canada.
J Cutan Med Surg. 2021 Sep;25(5):530-542. doi: 10.1177/1203475421995130. Epub 2021 Mar 2.
Idiopathic chilblains is a cold-induced inflammatory condition that causes significant morbidity. When preventative measures alone are inadequate, oral nifedipine is generally recommended as first-line pharmacologic therapy. Given the natural course of this spontaneously remitting/relapsing condition, controls are needed to critically appraise studies and determine the value of treatments. We report a systematic review of placebo-controlled or comparative therapeutic trials for the treatment of idiopathic chilblains. Our search of PubMed, Embase, and Cochrane databases, identified 11 studies that met our inclusion criteria for a combined study population = 576. Therapies included nifedipine, pentoxifylline, tadalafil, topical glyceryl trinitrate (GTN), topical minoxidil, diltiazem, corticosteroids, and vitamin D. There was moderate evidence to support the use of nifedipine and pentoxifylline in the treatment of severe or refractory cases of idiopathic chilblains, while other therapies had inadequate evidence or nonsignificant results compared to placebo.
特发性冻疮是一种由寒冷引起的炎症性疾病，会导致严重的发病率。当仅采取预防措施不足时，通常建议使用硝苯地平作为一线药物治疗。鉴于这种自发缓解/复发的情况的自然病程，需要对照来批判性地评估研究并确定治疗的价值。我们报告了一项针对特发性冻疮的安慰剂对照或比较治疗试验的系统评价。我们对 PubMed、Embase 和 Cochrane 数据库的搜索确定了 11 项符合我们纳入标准的研究，这些研究的综合研究人群为 576 人。治疗方法包括硝苯地平、己酮可可碱、他达拉非、硝酸甘油（GTN）、米诺地尔、地尔硫卓、皮质类固醇和维生素 D。有中等证据支持硝苯地平和己酮可可碱用于治疗特发性冻疮的严重或难治性病例，而其他疗法与安慰剂相比证据不足或结果无显著性差异。
