{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T02:00:52Z","timestamp":1776304852843,"version":"3.50.1"},"reference-count":27,"publisher":"Termedia Sp. z.o.o.","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Reumatologia"],"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Systemic sclerosis (SSc) is an autoimmune, connective tissue disorder of unknown etiology which causes vasculopathy and fibrosis. Raynaud\u2019s phenomenon (RP) is a common complication of SSc, which leads to ischemia and gangrenes. Treatment of RP is a clinical problem and often remains insufficient. \nThis study aimed to evaluate the therapeutic efficacy of local injections of botulinum toxin type A (BTX-A) in improving the symptoms of Raynaud\u2019s phenomenon (RP) secondary to scleroderma.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>This parallel single-blinded, placebo-controlled clinical trial enrolled 29 patients with scleroderma. Participants received BTX-A in the first, 2nd, 3rd, and 4th dorsal web spaces and the base of the thumb and small finger of the non-dominant hand and 2.5 ml of sterile normal saline in the opposite hand. Pre-injection measurements and post-injection follow-up evaluations at months 1 and 4 were performed. We compared the outcomes using the paired Student\u2019s t-test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The change in pain severity between pre-injection and month 1 follow-up was significantly \nlarger in the BTX-A group (p-value = 0.04). Between pre-injection and month 1 and month 4, \nthe changes in the Raynaud\u2019s condition score (RCS) (p-value = 0.02, 0.004, respectively) and the number of Raynaud\u2019s attacks (p-value = 0.006, 0.001, respectively) were significantly greater in the BTX-A group. No significant difference was found in terms of paresthesia, skin thickening, upper extremity function, ulcer diameter, number of ulcers, or Raynaud\u2019s attack duration between the two groups (p-value &gt; 0.05). In time, the decrease in pain severity, paresthesia, RCS, number of ulcers, and ulcer diameter, and the increase in upper extremity function were significantly greater in the BTX-A group as compared to the placebo group (p &lt; 0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our study showed that local injection of BTX-A is safe and has beneficial therapeutic effects on RP and RP-related digital ulcers in SSc patients.<\/jats:p><\/jats:sec>","DOI":"10.5114\/reum.2022.120757","type":"journal-article","created":{"date-parts":[[2023,1,11]],"date-time":"2023-01-11T11:39:38Z","timestamp":1673437178000},"page":"392-398","source":"Crossref","is-referenced-by-count":9,"title":["Efficacy of botulinum toxin type A injection for Raynaud\u2019s phenomenon and digital ulcers in patients with systemic sclerosis"],"prefix":"10.5114","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8926-5168","authenticated-orcid":false,"given":"Mohammad Hassan","family":"Jokar","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0614-8439","authenticated-orcid":false,"given":"Bita","family":"Baghbani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4366-6764","authenticated-orcid":false,"given":"Kiarash","family":"Roustai Geraylow","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9804-4559","authenticated-orcid":false,"given":"Jaleh","family":"Shariati","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8745-6558","authenticated-orcid":false,"given":"Hassan","family":"Mehrad-Majd","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2967-2404","authenticated-orcid":false,"given":"Zahra","family":"Mirfeizi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8879-6263","authenticated-orcid":false,"given":"Kamila","family":"Hashemzadeh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3061","published-online":{"date-parts":[[2022,12,30]]},"reference":[{"key":"ref-764855","doi-asserted-by":"publisher","DOI":"10.1038\/nrrheum.2010.102"},{"key":"ref-764856","doi-asserted-by":"publisher","DOI":"10.1172\/JCI31139"},{"key":"ref-764857","doi-asserted-by":"publisher","DOI":"10.1177\/2397198319863565"},{"key":"ref-764858","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2008.11.026"},{"key":"ref-764859","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2010.09.019"},{"key":"ref-764860","doi-asserted-by":"publisher","DOI":"10.5152\/eurjrheum.2018.18013"},{"key":"ref-764861","doi-asserted-by":"publisher","DOI":"10.1016\/j.rdc.2015.04.005"},{"key":"ref-764862","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0000000000000614"},{"key":"ref-764863","doi-asserted-by":"publisher","DOI":"10.5114\/aoms.2015.48152"},{"key":"ref-764864","doi-asserted-by":"publisher","DOI":"10.1002\/art.40123"},{"key":"ref-764865","doi-asserted-by":"publisher","DOI":"10.1016\/j.reuma.2020.04.006"},{"key":"ref-764866","doi-asserted-by":"publisher","DOI":"10.1002\/art.38098"},{"key":"ref-764867","doi-asserted-by":"publisher","DOI":"10.1002\/art.27584"},{"key":"ref-764868","doi-asserted-by":"publisher","DOI":"10.1002\/acr.20543"},{"key":"ref-764869","first-page":"1281","article-title":"Inter and intraobserver variability of total skin thickness score (modified Rodnan TSS) in systemic sclerosis","volume":"22","author":"Clements P","year":"1995","unstructured":"Clements P, Lachenbruch P, Siebold J, . 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