Evaluation of Botulinum Toxin Type A and its Potential Effect on Exacerbated Raynaud's Phenomenon in Hospitalized Scleroderma Patients.

Abstract

Raynaud's phenomenon by episodically reversible constriction of the arteries in the fingers and toes causes pain, numbness, sores, and gangrene. However, the treatment of Raynaud's phenomenon is one of the clinical issues. Recent studies have shown that botulinum toxin is considered a potential and effective therapeutic option for improving finger blood circulation in patients with Raynaud's syndrome. In this study, we sought to investigate the therapeutic effect of botulinum toxin type A on exacerbated Raynaud's phenomenon in patients with scleroderma. In this prospective study, 11 patients with systemic scleroderma who were referred due to aggravated Raynaud's were included. For all patients, questionnaires were filled up, and physical examination was performed separately for both treatment and control hands, and then similar volumes of botulinum toxin type A (Botox) and normal saline were randomly injected. The results showed that there was a significant difference in Raynaud's score (P = 0.001), Quick-Dash score (P = 0.01), Mc-Cabe cold score (P = 0.003), the mean frequency of recurrences arracks (P = 0.01), pain (0.005) (P = 0), skin color (P = 0.01), and duration of Raynaud's phenomenon (P = 0.006) between the intervention and control groups after two months. Following Botox injection, a significant improvement in terms of various Raynaud's parameters as well as the clinical manifestations was observed in the intervention group. Together, botulinum toxin type A could retrieve the hand function, the cold sensitivity, and the painful feeling caused by Raynaud's syndrome.