Seminars in Arthritis and Rheumatism
Volume 40, Issue 2 , Pages 137-146 , October 2010

Systemic Sclerosis: Bilateral Improvement of Raynaud's Phenomenon with Unilateral Digital Sympathectomy

  • Amy Wasserman, MD

      Affiliations

    • Rheumatology Fellow, Division of Rheumatology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA
    • ,
  • Ernest Brahn, MD

      Affiliations

    • Professor of Medicine, Division of Rheumatology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA
    • Corresponding Author InformationAddress reprint requests to: Ernest Brahn, MD, Division of Rheumatology, UCLA School of Medicine, 1000 Veteran Ave., Room 32-59, Los Angeles, CA 90095-1670

References 

  1. Ferri C, Valentini G, Cozzi F, Sebastiani M, Michelassi C, La MG, et al. Systemic sclerosis: demographic, clinical, and serologic features and survival in 1,012 Italian patients. Medicine (Baltimore). 2002;81(2):139–153
  2. Merkel PA, Herlyn K, Martin RW, Anderson JJ, Mayes MD, Bell P, et al. Measuring disease activity and functional status in patients with scleroderma and Raynaud's phenomenon. Arthritis Rheum. 2002;46(9):2410–2420
  3. Chung L, Fiorentino D. Digital ulcers in patients with systemic sclerosis. Autoimmun Rev. 2006;5(2):125–128
  4. Chung L. Therapeutic options for digital ulcers in patients with systemic sclerosis. J Dtsch Dermatol Ges. 2007;5(6):460–465
  5. Wigley FM. Clinical practice (Raynaud's Phenomenon). N Engl J Med. 2002;347(13):1001–1008
  6. Flavahan NA. Regulation of vascular reactivity in scleroderma: new insights into Raynaud's phenomenon. Rheum Dis Clin North Am. 2008;34(1):81–87
  7. Pope JE. Raynaud's phenomenon (primary). Clin Evid (Online) [2008 http://clinicalevidence.bmj.com/ceweb/index.jsp:[1119] Available from: URL:PM:19445785.
  8. Zandman-Goddard G, Tweezer-Zaks N, Shoenfeld Y. New therapeutic strategies for systemic sclerosis—a critical analysis of the literature. Clin Dev Immunol. 2005;12(3):165–173
  9. Kopelman D, Hashmonai M. The correlation between the method of sympathetic ablation for palmar hyperhidrosis and the occurrence of compensatory hyperhidrosis: a review. World J Surg. 2008;32(11):2343–2356
  10. Thune TH, Ladegaard L, Licht PB. Thoracoscopic sympathectomy for Raynaud's phenomenon—a long term follow-up study. Eur J Vasc Endovasc Surg. 2006;32(2):198–202
  11. Flatt AE. Digital artery sympathectomy. J Hand Surg [Am]. 1980;5(6):550–556
  12. Medsger TA, Silman AJ, Steen VD, Black CM, Akesson A, Bacon PA, et al. A disease severity scale for systemic sclerosis: development and testing. J Rheumatol. 1999;26(10):2159–2167
  13. Medsger TA, Bombardieri S, Czirjak L, Scorza R, Della RA, Bencivelli W. Assessment of disease severity and prognosis. Clin Exp Rheumatol. 2003;21(3 Suppl 29):S42–S46
  14. Meyer OC, Fertig N, Lucas M, Somogyi N, Medsger TA. Disease subsets, antinuclear antibody profile, and clinical features in 127 French and 247 US adult patients with systemic sclerosis. J Rheumatol. 2007;34(1):104–109
  15. Balbir-Gurman A, Braun-Moscovici Y, Nahir AM. Cocaine-induced raynaud's phenomenon and ischaemic finger necrosis. Clin Rheumatol. 2001;20(5):376–378
  16. Leithauser B, Langheinrich AC, Rau WS, Tillmanns H, Matthias FR. A 22-year-old woman with lower limb arteriopathy. Buerger's disease, or methamphetamine- or cannabis-induced arteritis? (Heart Vessels). 2005;20(1):39–43
  17. Zafren K. Gamow bag for high-altitude cerebral oedema. Lancet. 1998;352(9124):325–326
  18. Spiera RF. Systemic sclerosis and related syndromes. In:  Paget SA,  Gibofsky A,  Beary JF editor. Manual of rheumatology and outpatient orthopedic disorders. 4th ed.. New York (NY): Lippincott Williams & Wilkins; 2000;p. 252–257
  19. Tomaino MM, Goitz RJ, Medsger TA. Surgery for ischemic pain and Raynaud's phenomenon in scleroderma: a description of treatment protocol and evaluation of results. Microsurgery. 2001;21(3):75–79
  20. Thompson AE, Shea B, Welch V, Fenlon D, Pope JE. Calcium-channel blockers for Raynaud's phenomenon in systemic sclerosis. Arthritis Rheum. 2001;44(8):1841–1847
  21. Thompson AE, Pope JE. Calcium channel blockers for primary Raynaud's phenomenon: a meta-analysis. Rheumatology (Oxford). 2005;44(2):145–150
  22. Takahara K, Kuroiwa A, Matsushima T, Nakashima Y, Takasugi M. Effects of nifedipine on platelet function. Am Heart J. 1985;109(1):4–8
  23. Winston EL, Pariser KM, Miller KB, Salem DN, Creager MA. Nifedipine as a therapeutic modality for Raynaud's phenomenon. Arthritis Rheum. 1983;26(10):1177–1180
  24. Vinjar B, Stewart M. Oral vasodilators for primary Raynaud's phenomenon. Cochrane Database Syst Rev. 2008;2:CD006687
  25. Tucker AT, Pearson RM, Cooke ED, Benjamin N. Effect of nitric-oxide-generating system on microcirculatory blood flow in skin of patients with severe Raynaud's syndrome: a randomised trial. Lancet. 1999;354(9191):1670–1675
  26. Wheeland RG, Gilchrist RW, Young CJ. Treatment of ischemic digital ulcers with nitroglycerin ointment. J Dermatol Surg Oncol. 1983;9(7):548–551
  27. Belch J, Fiorentino D, Denton C, Herrick A, Sule S, Steen V, et al. MQX-503, a novel topical nitroglycerine formulation, improves severity of symptoms associated with Raynaud's phenomenon. Arthritis Rheum. 2008;58(Suppl):S622
  28. Chung L, Shapiro L, Fiorentino D, Baron M, Shanahan J, Sule S, et al. MQX-503, a novel formulation of nitroglycerin, improves the severity of Raynaud's phenomenon: a randomized, controlled trial. Arthritis Rheum. 2009;60(3):870–877
  29. Jaffe IA. Serotonin reuptake inhibitors in Raynaud's phenomenon. Lancet 1378;345(8961):1378.
  30. Coleiro B, Marshall SE, Denton CP, Howell K, Blann A, Welsh KI, et al. Treatment of Raynaud's phenomenon with the selective serotonin reuptake inhibitor fluoxetine. Rheumatology (Oxford). 2001;40(9):1038–1043
  31. Warren JB, Loi RK. Captopril increases skin microvascular blood flow secondary to bradykinin, nitric oxide, and prostaglandins. FASEB J. 1995;9(5):411–418
  32. Wood HM, Ernst ME. Renin-angiotensin system mediators and Raynaud's phenomenon. Ann Pharmacother. 2006;40(11):1998–2002
  33. Dziadzio M, Denton CP, Smith R, Howell K, Blann A, Bowers E, et al. Losartan therapy for Raynaud's phenomenon and scleroderma: clinical and biochemical findings in a fifteen-week, randomized, parallel-group, controlled trial. Arthritis Rheum. 1999;42(12):2646–2655
  34. Gliddon AE, Dore CJ, Black CM, McHugh N, Moots R, Denton CP, et al. Prevention of vascular damage in scleroderma and autoimmune Raynaud's phenomenon: a multicenter, randomized, double-blind, placebo-controlled trial of the angiotensin-converting enzyme inhibitor quinapril. Arthritis Rheum. 2007;56(11):3837–3846
  35. Heymann WR. Sildenafil for the treatment of Raynaud's phenomenon. J Am Acad Dermatol. 2006;55(3):501–502
  36. Gore J, Silver R. Oral sildenafil for the treatment of Raynaud's phenomenon and digital ulcers secondary to systemic sclerosis. Ann Rheum Dis 1387;64(9):1387.
  37. Della Rossa A, Doveri A, Tavoni A, Consensi A, Neri R, Bazzichi L, et al. Oral sildenafil in skin ulcers secondary to systemic sclerosis. Ann Rheum Dis [2009 http://www.abstracts2view.com/eular/:[THU0291].
  38. Becker M, Bruckner CS, Scherer H, Burmester GR, Riemekasten G. Effect of Sildenafil on digital ulcers in systemic sclerosis-analysis from a single centre study. Ann Rheum Dis [2009 http://www.abstracts2view.com/eular/:[OP0080].
  39. Fries R, Shariat K, von WH, Bohm M. Sildenafil in the treatment of Raynaud's phenomenon resistant to vasodilatory therapy. Circulation. 2005;112(19):2980–2985
  40. Shenoy P, Agarwal V, Chaudhary SK, Jha LK, Singh U, Misra R, et al. Efficacy of tadalafil in secondary raynaud's phenomenon resistant to vasodilator therapy: a double blind randomized cross over trial. Arthritis Rheum. 2008;58(Suppl):S402
  41. Neirotti M, Longo F, Molaschi M, Macchione C, Pernigotti L. Functional vascular disorders: treatment with pentoxifylline. Angiology. 1987;38(8):575–580
  42. Hettema ME, Zhang D, Bootsma H, Kallenberg CG. Bosentan therapy for patients with severe Raynaud's phenomenon in systemic sclerosis. Ann Rheum Dis. 2007;66(10):1398–1399
  43. Hafner F, Gary T, Froehlicch H, Pilger E, Brodmann M. The effect of a single line therapy with bosentan versus a sequential therapy of prostanoids and bosentan in the treatment of digital skin ulcers in severe scleroderma. Ann Rheum Dis [2009 http://www.abstracts2view.com/eular/:[AB0382].
  44. Korn JH, Mayes M, Matucci CM, Rainisio M, Pope J, Hachulla E, et al. Digital ulcers in systemic sclerosis: prevention by treatment with bosentan, an oral endothelin receptor antagonist. Arthritis Rheum. 2004;50(12):3985–3993
  45. Pakozdi A, Howell K, Wilson H, Fox S, Gonzalez L, Black CM, et al. Inhaled iloprost for the treatment of Raynaud's phenomenon. Clin Exp Rheumatol 709;26(4):709.
  46. Kawald A, Burmester GR, Huscher D, Sunderkotter C, Riemekasten G. Low versus high-dose iloprost therapy over 21 days in patients with secondary Raynaud's phenomenon and systemic sclerosis: a randomized, open, single-center study. J Rheumatol. 2008;35(9):1830–1837
  47. Pope J, Fenlon D, Thompson A, Shea B, Furst D, Wells G, et al. Iloprost and cisaprost for Raynaud's phenomenon in progressive systemic sclerosis. Cochrane Database Syst Rev. 2000;2:CD000953
  48. Badesch DB, Tapson VF, McGoon MD, Brundage BH, Rubin LJ, Wigley FM, et al. Continuous intravenous epoprostenol for pulmonary hypertension due to the scleroderma spectrum of disease (A randomized, controlled trial). Ann Intern Med. 2000;132(6):425–434
  49. Engel G, Rockson SG. Treprostinil for the treatment of severe digital necrosis in systemic sclerosis. Vasc Med. 2005;10(1):29–32
  50. Abou-Raya A, Abou-Raya S, Helmii M. Statins: potentially useful in therapy of systemic sclerosis-related Raynaud's phenomenon and digital ulcers. J Rheumatol. 2008;35(9):1801–1808
  51. Ozgocmen S, Kaya A, Coskun BK. Topical lidocaine helps reduce pain of digital ulcers in systemic sclerosis (scleroderma). Clin Rheumatol. 2006;25(3):378–379
  52. Muir AH, Robb R, McLaren M, Daly F, Belch JJ. The use of Ginkgo biloba in Raynaud's disease: a double-blind placebo-controlled trial. Vasc Med. 2002;7(4):265–267
  53. Malenfant D, Catton M, Pope JE. The efficacy of complementary and alternative medicine in the treatment of Raynaud's phenomenon: a literature review and meta-analysis. Rheumatology (Oxford). 2009;48(7):791–795
  54. Jones NF. Surgical approach to hand involvement. In:  Clements PJ,  Furst DE editor. Systemic sclerosis. 1st ed.. Philadelphia (PA): Williams & Wilkins; 1996;p. 569–577
  55. Engelhart M. The effect of sympathetic blockade and cooling in Raynaud's phenomenon. Clin Physiol. 1990;10(2):131–136
  56. Klyscz T, Junger M, Meyer H, Rassner G. Improvement of acral circulation in a patient with systemic sclerosis with stellate blocks. Vasa. 1998;27(1):39–42
  57. Van Beek AL, Lim PK, Gear AJ, Pritzker MR. Management of vasospastic disorders with botulinum toxin A. Plast Reconstr Surg. 2007;119(1):217–226
  58. Kossintseva I, Barankin B. Improvement in both Raynaud disease and hyperhidrosis in response to botulinum toxin type A treatment. J Cutan Med Surg. 2008;12(4):189–193
  59. Chwajol M, Barrenechea IJ, Chakraborty S, Lesser JB, Connery CP, Perin NI. Impact of compensatory hyperhidrosis on patient satisfaction after endoscopic thoracic sympathectomy. Neurosurgery. 2009;64(3):511–518
  60. Walles T, Somuncuoglu G, Steger V, Veit S, Friedel G. Long-term efficiency of endoscopic thoracic sympathicotomy: survey 10 years after surgery. Interact Cardiovasc Thorac Surg. 2009;8(1):54–57
  61. De Trafford JC, Lafferty K, Potter CE, Roberts VC, Cotton LT. An epidemiological survey of Raynaud's phenomenon. Eur J Vasc Surg. 1988;2(3):167–170
  62. Matsumoto Y, Ueyama T, Endo M, Sasaki H, Kasashima F, Abe Y, et al. Endoscopic thoracic sympathicotomy for Raynaud's phenomenon. J Vasc Surg. 2002;36(1):57–61
  63. Maga P, Kuzdzal J, Nizankowski R, Szczeklik A, Sladek K. Long-term effects of thoracic sympathectomy on microcirculation in the hands of patients with primary Raynaud disease. J Thorac Cardiovasc Surg. 2007;133(6):1428–1433
  64. Marhold F, Izay B, Zacherl J, Tschabitscher M, Neumayer C. Thoracoscopic and anatomic landmarks of Kuntz's nerve: implications for sympathetic surgery. Ann Thorac Surg. 2008;86(5):1653–1658
  65. Valley MA, Rogers JN, Gale DW. Relief of recurrent upper extremity sympathetically-maintained pain with contralateral sympathetic blocks: evidence for crossover sympathetic innervation?. J Pain Symptom Manage. 1995;10(5):396–400
  66. Ramsaroop L, Partab P, Singh B, Satyapal KS. Thoracic origin of a sympathetic supply to the upper limb: the ‘nerve of Kuntz’ revisited. J Anat. 2001;199(Pt. 6):675–682
  67. Hafner J, Della SD, Zuber C, Christen Y, Bounameaux H. Digital sympathectomy (microarteriolysis) in the treatment of severe Raynaud's phenomenon secondary to systemic sclerosis. Br J Dermatol. 1997;137(6):1019–1020
  68. Pollock DC, Li Z, Rosencrance E, Krome J, Koman LA, Smith TL. Acute effects of periarterial sympathectomy on the cutaneous microcirculation. J Orthop Res. 1997;15(3):408–413
  69. Yee AM, Hotchkiss RN, Paget SA. Adventitial stripping: a digit saving procedure in refractory Raynaud's phenomenon. J Rheumatol. 1998;25(2):269–276
  70. Balogh B, Mayer W, Vesely M, Mayer S, Partsch H, Piza-Katzer H. Adventitial stripping of the radial and ulnar arteries in Raynaud's disease. J Hand Surg [Am]. 2002;27(6):1073–1080
  71. Wang WH, Lai CS, Chang KP, Lee SS, Yang CC, Lin SD, et al. Peripheral sympathectomy for Raynaud's phenomenon: a salvage procedure. Kaohsiung J Med Sci. 2006;22(10):491–499
  72. Kotsis SV, Chung KC. A systematic review of the outcomes of digital sympathectomy for treatment of chronic digital ischemia. J Rheumatol. 2003;30(8):1788–1792
  73. Nihtyanova SI, Denton CP. Current approaches to the management of early active diffuse scleroderma skin disease. Rheum Dis Clin North Am. 2008;34(1):161–179
  74. Nihtyanova SI, Brough GM, Black CM, Denton CP. Clinical burden of digital vasculopathy in limited and diffuse cutaneous systemic sclerosis. Ann Rheum Dis. 2008;67(1):120–123
  75. Marie I, Jouen F, Hellot MF, Levesque H. Anticardiolipin and anti-beta2 glycoprotein I antibodies and lupus-like anticoagulant: prevalence and significance in systemic sclerosis. Br J Dermatol. 2008;158(1):141–144
  76. Sunderkotter C, Herrgott I, Bruckner C, Moinzadeh P, Pfeiffer C, Gerss J, et al. Comparison of patients with and without digital ulcers in systemic sclerosis: detection of possible risk factors. Br J Dermatol. 2009;160(4):835–843
  77. Sledge CB. Principles of reconstructive surgery for arthritis. In:  Harris ED,  Budd RC,  Firestein GS,  Genovese MC,  Sergent JS,  Ruddy S, et al. editor. Kelley's textbook of rheumatology. 7th ed.. Philadelphia (PA): Elsevier Saunders; 2005;p. 1836–1852
  78. Boin F, Wigley FM. Understanding, assessing and treating Raynaud's phenomenon. Curr Opin Rheumatol. 2005;17(6):752–760
  79. Freedman RR, Moten M, Migaly P, Mayes M. Cold-induced potentiation of alpha 2-adrenergic vasoconstriction in primary Raynaud's disease. Arthritis Rheum. 1993;36(5):685–690
  80. Chotani MA, Flavahan S, Mitra S, Daunt D, Flavahan NA. Silent alpha(2C)-adrenergic receptors enable cold-induced vasoconstriction in cutaneous arteries. Am J Physiol Heart Circ Physiol. 2000;278(4):H1075–H1083
  81. Bailey SR, Eid AH, Mitra S, Flavahan S, Flavahan NA. Rho kinase mediates cold-induced constriction of cutaneous arteries: role of alpha2C-adrenoceptor translocation. Circ Res. 2004;94(10):1367–1374
  82. Zamora MR, O'Brien RF, Rutherford RB, Weil JV. Serum endothelin-1 concentrations and cold provocation in primary Raynaud's phenomenon. Lancet. 1990;336(8724):1144–1147
  83. Furspan PB, Chatterjee S, Freedman RR. Increased tyrosine phosphorylation mediates the cooling-induced contraction and increased vascular reactivity of Raynaud's disease. Arthritis Rheum. 2004;50(5):1578–1585
  84. Furspan PB, Chatterjee S, Mayes MD, Freedman RR. Cooling-induced contraction and protein tyrosine kinase activity of isolated arterioles in secondary Raynaud's phenomenon. Rheumatology (Oxford). 2005;44(4):488–494
  85. Beretta L, Cossu M, Marchini M, Cappiello F, Artoni A, Motta G, et al. A polymorphism in the human serotonin 5-HT2A receptor gene may protect against systemic sclerosis by reducing platelet aggregation. Arthritis Res Ther. 2008;10(5):R103
  86. Fraenkel L, Zhang Y, Chaisson CE, Evans SR, Wilson PW, Felson DT. The association of estrogen replacement therapy and the Raynaud phenomenon in postmenopausal women. Ann Intern Med. 1998;129(3):208–211
  87. Freedman RR, Girgis R, Mayes MD. Acute effect of nitric oxide on Raynaud's phenomenon in scleroderma. Lancet 739;354(9180):739.
  88. Lindblad LE, Shepherd JT, Vanhoutte PM. Cooling augments platelet-induced contraction of peripheral arteries of the dog. Proc Soc Exp Biol Med. 1984;176(2):119–122
  89. Gofeld M, Faclier G. Bilateral pain relief after unilateral thoracic percutaneous sympathectomy. Can J Anaesth. 2006;53(3):258–262
  90. van Maanen MA, Vervoordeldonk MJ, Tak PP. The cholinergic anti-inflammatory pathway: towards innovative treatment of rheumatoid arthritis. Nat Rev Rheumatol. 2009;5(4):229–232
  91. Abeles M, Abeles A. Phosphodiesterase inhibitor tadalafil in the treatment of ischemic digital ulcers/digital necrosis due to scleroderma-associated raynaud's phenomenon. Arthritis Rheum. 2008;58(Suppl):S822
  92. Snyder MJ, Jacobs MR, Grau RG, Wilkes DS, Knox KS. Resolution of severe digital ulceration during a course of Bosentan therapy. Ann Intern Med. 2005;142(9):802–803
  93. Blagojevic J, Matucci-Cerinic M. Are statins useful for treating vascular involvement in systemic sclerosis?. Nat Clin Pract Rheumatol. 2009;5(2):70–71
  94. van de Wal HJ, Skotnicki SH, Wijn PF, Lacquet LK. Thoracic sympathectomy as a therapy for upper extremity ischemia (A long-term follow-up study). Thorac Cardiovasc Surg. 1985;33(3):181–187
  95. Kossintseva I, Barankin B. Improvement in both Raynaud disease and hyperhidrosis in response to botulinum toxin type A treatment. J Cutan Med Surg. 2008;12(4):189–193
  96. Tjiu JW, Lin SJ, Wang LF, Shih JY, Yu CJ, Liang CW, et al. Digital infarcts showing microangiopathy in adult dermatomyositis suggest severe pulmonary involvement and poor prognosis. Br J Dermatol. 2004;150(6):1214–1216
  97. Yosipovitch G, Feinmesser M, David M. Adult dermatomyositis with livedo reticularis and multiple skin ulcers. J Eur Acad Dermatol Venereol. 1998;11(1):48–50
  98. D'Cruz D. Vasculitis in systemic lupus erythematosus. Lupus. 1998;7(4):270–274
  99. Nagai Y, Shimizu A, Ishikawa O. Successful treatment with bosentan for refractory digital ulcers in a patient with systemic lupus erythematosus. J Dermatol. 2008;35(7):447–451
  100. Cakir O, Ayyildiz O, Isikdogan A. Type III mixed cryoglobulinemia associated with digital necrotic ulcer successfully treated with intermittent intravenous pulse cyclophosphamide—a case report. Angiology. 2005;56(4):489–492
  101. Erhardt CC, Mumford P, Maini RN. The association of cryoglobulinaemia with nodules, vasculitis and fibrosing alveolitis in rheumatoid arthritis and their relationship to serum C1q binding activity and rheumatoid factor. Clin Exp Immunol. 1979;38(3):405–413
  102. Chen KR, Carlson JA. Clinical approach to cutaneous vasculitis. Am J Clin Dermatol. 2008;9(2):71–92
  103. Carlson JA, Cavaliere LF, Grant-Kels JM. Cutaneous vasculitis: diagnosis and management. Clin Dermatol. 2006;24(5):414–429
  104. Schneider HA, Yonker RA, Katz P, Longley S, Panush RS. Rheumatoid vasculitis: experience with 13 patients and review of the literature. Semin Arthritis Rheum. 1985;14(4):280–286
  105. Vollertsen RS, Conn DL. Vasculitis associated with rheumatoid arthritis. Rheum Dis Clin North Am. 1990;16(2):445–461
  106. Ben GI, Dhrif AS, Miled M, Houman MH. [Cutaneous manifestations as the initial presentation of Wegener's granulomatosis]. Presse Med. 2007;36(4 Pt 1):619–622
  107. Irvine AD, Bruce IN, Walsh M, Burrows D, Handley J. Dermatological presentation of disease associated with antineutrophil cytoplasmic antibodies: a report of two contrasting cases and a review of the literature. Br J Dermatol. 1996;134(5):924–928
  108. Foley S, Gibbs H, Muir J. Painful digital infarction in a male smoker treated as Buerger's disease. Australas J Dermatol. 2008;49(2):94–97
  109. Mills JL. Buerger's disease in the 21st century: diagnosis, clinical features, and therapy. Semin Vasc Surg. 2003;16(3):179–189
  110. Costenbader KH, Fidias P, Gilman MD, Qureshi A, Tambouret RH. Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises (Case 29-2006. A 43-year-old woman with painful nodules on the fingertips, shortness of breath, and fatigue). N Engl J Med. 2006;355(12):1263–1272
  111. Garcia Padilla CE, Quintanilla L. [24-year-old woman with hematuria, mental changes, loss of visual acuity and ulcers on the fingers]. Rev Invest Clin. 1990;42(1):68–74
  112. Enelow RS, Hussein M, Grant K, Cupps TR, Druckman D, Mortazavi A, et al. Vasculitis with eosinophilia and digital gangrene in a patient with acquired immunodeficiency syndrome. J Rheumatol. 1992;19(11):1813–1816
  113. Libman BS, Quismorio FP, Stimmler MM. Polyarteritis nodosa-like vasculitis in human immunodeficiency virus infection. J Rheumatol. 1995;22(2):351–355
  114. Vayssairat M, Gaitz JP, Bamberger N. Digital gangrene, HIV infection and bleomycin treatment. J Rheumatol 921;20(5):921.
  115. Au WY, Jim MH, Lam KY, Kwong YL. Digital gangrene and a mass in the heart. Arch Intern Med. 2001;161(2):292–293
  116. Kumpe DA, Zwerdlinger S, Griffin DJ. Blue digit syndrome: treatment with percutaneous transluminal angioplasty. Radiology. 1988;166(1 Pt. 1):37–44
  117. Lane JE, Lane TN, Shams M, Lane CE. Cutaneous cholesterol embolization. J Am Acad Dermatol. 2009;60(4):711–713
  118. Burruss JB, Cohen LM, Thomas HA, Callen JP. Unilateral emboli in a patient with thrombotic thrombocytopenic purpura. J Am Acad Dermatol. 1993;29(5 Pt 2):838–840
  119. Molos MA, Hall JC. Symmetrical peripheral gangrene and disseminated intravascular coagulation. Arch Dermatol. 1985;121(8):1057–1061
  120. Singer RM, Gorosh JE. Purpura fulminans. J Hand Surg [Am]. 1990;15(1):172–175
  121. Peyrot I, Garsaud AM, Saint-Cyr I, Quitman O, Sanchez B, Quist D. Cannabis arteritis: a new case report and a review of literature. J Eur Acad Dermatol Venereol. 2007;21(3):388–391
  122. Voyvodic F, Hayward M. Case report: upper extremity ischaemia secondary to ergotamine poisoning. Clin Radiol. 1996;51(8):589–591
  123. Wollina U, Hansel G, Gruner M, Schonlebe J, Heinig B, Kostler E. Painful ANA-positive scleroderma-like disease with acral ulcerations: a case of chronic gangrenous ergotism. Int J Low Extrem Wounds. 2007;6(3):148–152
  124. Ferris BL, Taylor LM, Oyama K, McLafferty RB, Edwards JM, Moneta GL, et al. Hypothenar hammer syndrome: proposed etiology. J Vasc Surg. 2000;31(1 Pt. 1):104–113
  125. Karimi KM, Perlmutter AE, Freeman BG. Overuse-related vascular injury of the hand—hypothenar hammer syndrome: a case report. WV Med J. 2005;101(6):250–252
  126. Marie I, Herve F, Primard E, Cailleux N, Levesque H. Long-term follow-up of hypothenar hammer syndrome: a series of 47 patients. Medicine (Baltimore). 2007;86(6):334–343
  127. Hedrich CM, Fiebig B, Hauck FH, Sallmann S, Hahn G, Pfeiffer C, et al. Chilblain lupus erythematosus—a review of literature. Clin Rheumatol. 2008;27(8):949–954
  128. McCleskey PE, Winter KJ, Devillez RL. Tender papules on the hands (Idiopathic chilblains (perniosis)). Arch Dermatol. 2006;142(11):1501–1506
  129. Ohtsuka T, Yamakage A, Yamazaki S. Digital ulcers and necroses: novel manifestations of angiocentric lymphoma. Br J Dermatol. 2000;142(5):1013–1016
  130. Pronk WG, Baars JP, De Jong PC, Westermann AM. Some unusual paraneoplastic syndromes (Case 2. Digital ulceration as a paraneoplastic syndrome in ovarian cancer). J Clin Oncol. 2003;21(13):2620–2622
  131. Tan BB, Lear JT, English JS. Metastasis from carcinoma of breast masquerading as chilblains. J R Soc Med 162;90(3):162.
  132. Freedman RR, Baer RP, Mayes MD. Blockade of vasospastic attacks by alpha 2-adrenergic but not alpha 1-adrenergic antagonists in idiopathic Raynaud's disease. Circulation. 1995;92(6):1448–1451
  133. Bailey SR, Mitra S, Flavahan S, Flavahan NA. Reactive oxygen species from smooth muscle mitochondria initiate cold-induced constriction of cutaneous arteries. Am J Physiol Heart Circ Physiol. 2005;289(1):H243–H250
  134. Bottomley W, Goodfield M. A pathogenic role for endothelin in Raynaud's phenomenon?. Acta Derm Venereol. 1994;74(6):433–434

 The authors have no conflicts of interest to disclose.

PII: S0049-0172(09)00097-3

doi: 10.1016/j.semarthrit.2009.08.002

Seminars in Arthritis and Rheumatism
Volume 40, Issue 2 , Pages 137-146 , October 2010

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