Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, New York.
Department of Dermatology, Lahey Hospital and Medical Center, Burlington, Massachusetts.
J Am Acad Dermatol. 2024 Feb;90(2):237-248. doi: 10.1016/j.jaad.2022.05.067. Epub 2022 Jul 6.
Raynaud phenomenon (RP) presents with either primary or secondary disease, and both have the potential to negatively impact patient quality of life. First-line management of RP should include lifestyle modifications in all patients. Some patients with primary RP and most with secondary RP require pharmacologic therapies, which may include calcium channel blockers, topical nitrates, phosphodiesterase 5 inhibitors, or endothelin antagonists. Additional approaches to treatment for those with signs of critical ischemia or those who fail pharmacologic therapy include botulinum toxin injection and digital sympathectomy. Herein, we describe in detail the treatment options for patients with RP as well as provide treatment algorithms for each RP subtype.
雷诺现象(RP)表现为原发性或继发性疾病,两者都有可能降低患者的生活质量。RP 的一线治疗应包括所有患者的生活方式改变。一些原发性 RP 患者和大多数继发性 RP 患者需要药物治疗,包括钙通道阻滞剂、局部硝酸酯类、磷酸二酯酶 5 抑制剂或内皮素拮抗剂。对于有严重缺血迹象或药物治疗失败的患者,可选择肉毒毒素注射和数字交感神经切除术。本文详细描述了 RP 患者的治疗选择,并为每种 RP 亚型提供了治疗方案。