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                        ==RAYNAUD SYNDROME==

11
AUTHOR                    Bolster MB
AUTHOR                    Maricq HR
AUTHOR                    Leff RL
TITLE                     Office evaluation and treatment of Raynaud's
                          phenomenon.
SOURCE                    Cleve Clin J Med 1995 Jan-Feb;62(1):51-61

ABSTRACT                  BACKGROUND: Raynaud's phenomenon, an episodic
                          vascular disorder induced by cold
                          temperatures or stress and characterized by
                          white, blue, and red discoloration of the
                          fingers and toes, may affect up to 20% of the
                          general population. KEY POINTS: Raynaud's
                          phenomenon may exist independently (primary)
                          or in association with an underlying disease
                          (secondary), most commonly systemic
                          sclerosis. The pathophysiologic features
                          include vasospasm, endothelial cell changes,
                          vessel obstructive features, and
                          hemorrheologic factors. Raynaud's phenomenon
                          is the initial manifestation of disease in
                          70% of patients with systemic sclerosis, in
                          whom it may be present for many years before
                          the development of the connective tissue
                          disease. Patients with primary Raynaud's
                          phenomenon need only conservative management
                          and should be reassured that digital ischemia
                          and loss of tissue occur extremely rarely.
                          Pharmacologic agents that have been studied
                          include vasodilators, platelet inhibitors,
                          serotonin antagonists, and fibrinolytics.
                          CONCLUSIONS: For prognostic and therapeutic
                          reasons, it is important to determine if
                          Raynaud's phenomenon is associated with an
                          underlying condition and if the patient may
                          develop a connective tissue disease.

3
AUTHOR                    Haustein UF
TITLE                     [Raynaud phenomenon and scleroderma]
SOURCE                    Hautarzt 1996 May;47(5):336-40
ABSTRACT                  The Raynaud phenomenon occurs in 90-100% of
                          patients with systemic scleroderma. It is
                          caused by dysregulation of the vascular tone
                          between vasoconstrictive and vasodilatory
                          influences. Early damage to the vascular
                          endothelium and the activation of platelets
                          lead to the release of vasoactive substances.
                          Structural and function impairment of the
                          perivascular neural fibers contributes to the
                          vasospasm. New vasodilatory treatment
                          strategies, e.g. infusions with calcitonin
                          gene-related peptides, could be useful in the
                          control of vasospasm in the peripheral
                          extremities as well as internal organs in
                          systemic scleroderma.

9
AUTHOR                    Helfman T
AUTHOR                    Falanga V
TITLE                     Stanozolol as a novel therapeutic agent in
                          dermatology.
SOURCE                    J Am Acad Dermatol 1995 Aug;33(2 Pt 1):254-8
ABSTRACT                  Anabolic steroids are synthetic derivatives
                          of testosterone that were developed in the
                          1950s in an attempt to dissociate the
                          anabolic and androgenic effects of
                          testosterone. The anabolic steroid stanozolol
                          has been particularly helpful because it has
                          one of the largest anabolic/androgenic
                          ratios. In addition, stanozolol has
                          substantial fibrinolytic properties. We
                          discuss the safety profile and the use of
                          stanozolol for a variety of clinical
                          applications. Stanozolol is approved for use
                          in the treatment of hereditary angioedema,
                          but numerous reports have detailed the
                          effectiveness of this agent in the treatment
                          of urticaria, Raynaud's phenomenon, and, more
                          recently, cryofibrinogenemia and
                          lipodermatosclerosis. Side effects are mostly
                          dose related and are preventable with
                          appropriate follow-up.