The Effect of Iproniazid Ointment on Trophic Ulcers Associated with Raynaud’s Phenomenon

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TROPHIC ulcers of the finger tips may occur as a complication of Raynaud’s phenomenon. Usually they are painful and cause considerable discomfort.In general, therapy is unsatisfactory. Although sympathectomy often results in healing of the ulcers, they are likely to recur. Medical treatment with vasodilators and blocking agents are of questionable value.1 The local application of glyceryl trinitrate has been reported2 to be effective in the relief of Raynaud’s phenomenon, though an annoying headache may occur as a side effect of treatment.3 In our experience this treatment has had little influence on gangrenous ulcers.

During the past five years we have used iproniazid* ointment, from 2 to 5 per cent in a water-soluble base, in the treatment of 23 patients. This group consisted of 14 patients with progressive systemic sclerosis and five patients with acrosclerosis complicated by ulceration of the finger tips, two patients with systemic lupus erythematosus in whom painful ulcerations appeared over interphalangeal joints, and two patients with advanced Raynaud’s disease in whom painful ulcerations of the finger tips developed within six months and one year, respectively, after sympathectomy.

The ointment was applied twice daily to the ulcers, and the fingers were wrapped lightly with gauze. Within from 24 to 72 hours pain disappeared, and after a few weeks the ulcers usually healed (Fig. 1). Of the group of 23 patients, 19 had complete relief of pain, and 18 had complete healing of the ulcers. However, eight patients had recurrence of pain and ulcers within from three weeks to. . .



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