Optimisation of botulinum toxin type a treatment for the management of Raynaud’s phenomenon using a dorsal approach: a prospective case series

• DOI: 10.1007/s10067-019-04762-4
• Publication Date: 2019-09-03T11:12:18Z
• Authors: Kiran Dhaliwal; Michelle F. Griffin; Sebastian Salinas; Kevin Howell; Christopher P. De...; Peter E.M. Butler
• Keywords: Adult; Botox; Raynaud Disease; Middle Aged; Vasospasm; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Neuromuscular Agents; Botulinum toxin; Thermography; Raynauds phenomenon; Systemic sclerosis; Humans; Female; Prospective Studies; Botulinum Toxins, Type A; Aged

Raynaud's phenomenon (RP) is a common condition and causes pain, paraesthesia, ulceration gangrene. Botulinum toxin A (Btx-A) effective when injected via digital palmar approach, in the treatment of severe RP. However, hand weakness resulting from lumbrical malfunction recognized complication. This study aimed to determine effect Btx-A dorsal approach. Forty patients received 100 units Btx-A, across both hands Each patient had baseline, 6- 12-week assessment thermographic image (FLIR E60bx) performed for study. Eighty-eight percent reported an improvement symptoms including reduction improved colour change with reduced swelling edema at 6 weeks. Of these patients, 80% cold intolerance frequency severity attacks. There was significant DASH score (p = 0.001), Kapandji 0.001) strength < 0.05). No weakness. Improvements function RP were still evident 12 approach improves reduces number We have shown non-surgical technique treat