Mary Pack Vasculitis Clinic, Division of Rheumatology, Department of Medicine, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
Toronto Scleroderma Program, Division of Rheumatology, Department of Medicine, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
Best Pract Res Clin Rheumatol. 2021 Sep;35(3):101684. doi: 10.1016/j.berh.2021.101684. Epub 2021 May 5.
Raynaud's phenomenon (RP) is common in rheumatic diseases. In the setting of systemic sclerosis (SSc), it can be complicated by digital ischemia that includes ulceration and gangrene. Systemic adverse effects may preclude the use of oral or topical vasodilators for the treatment of RP and its complications. In this article, we review effectiveness/efficacy of botulinum toxin injection in primary and secondary RP. We discuss botulinum toxin formulations, dosage, sites of administration, and adverse effects. The evidence for botulinum toxin in the treatment of primary and SSc-associated RP is promising. Consistency across patient populations, treatment options (botulinum serotype, dose, and injection site), and outcome measures will be essential for further research.
雷诺现象（RP）在风湿性疾病中较为常见。在系统性硬化症（SSc）中，它可能会导致包括溃疡和坏疽在内的手指缺血。全身性不良反应可能会限制口服或局部血管扩张剂治疗 RP 及其并发症的应用。本文综述了肉毒毒素注射治疗原发性和继发性 RP 的疗效。我们讨论了肉毒毒素制剂、剂量、给药部位和不良反应。肉毒毒素治疗原发性和 SSc 相关 RP 的证据是有前景的。进一步的研究需要患者人群、治疗选择（肉毒毒素血清型、剂量和注射部位）和结果测量的一致性。
