ISSN:
1524-475X
Source:
Blackwell Publishing Journal Backfiles 1879-2005
Topics:
Medicine
Notes:
Background: More than three quarters of patients with a connective tissue disorder will develop secondary Raynauld’s disease. This more severe form of the Raynauld’s can lead to digital ischemia, tissue loss and may even result in the need for amputation of one or more digits. Cilostazol is a phosphodiesterase inhibitor currently approved for use in vascular disease of the lower extremities. Case History: In August of 2002 a 62 year old female pianist with scleroderma presented to the wound clinic with a two year history of intractable digital pain secondary to ischemic ulcerations of the index, long and ring fingers of the right hand. She suffered from secondary Raynauld’s disease. Prior unsuccessful treatments included warming the hands, calcium channel blockade, anticoagulation, topical xylocaine and narcotic analgesics. In August of 2002 cilostazol was started at 100mg BID. Wound care consisted of serial debridement, moist wound healing and topical rhPDGF. Results: Four weeks into treatment the patient’s narcotic requirement decreased substantially and the fingers had a pink appearance. The ring finger healed after eight weeks. At three months the patient discontinued narcotic pain medication. Nine months into treatment the index finger had healed and she resumed playing the piano. The long finger finally healed one year after she initially presented to the wound clinic. Conclusion: Cilostazol may be an important adjunct in the treatment of secondary Raynauld’s disease particularly when digital ischemia has developed. Acknowledgements: Funding from Otsuka Pharmaceuticals.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1111/j.1067-1927.2004.0abstractx.x
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