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Secondary Raynaud’s Phenomenon and Skin Necrosis of Toes in the Paraplegic Patient with Hypertension

We present two cases of paraplegic patients who developed secondary Raynaud’s phenomenon. A 43-year-old man with paraplegia presented with dark purple discoloration and skin defects on his left second and third toes and complained of a cold sensation in both feet for a period of 1 year. He had been...

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Autores principales: Lee, Yong Jig, Park, Kisoo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5803170/
https://www.ncbi.nlm.nih.gov/pubmed/29417244
http://dx.doi.org/10.1007/s40800-018-0071-6
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author Lee, Yong Jig
Park, Kisoo
author_facet Lee, Yong Jig
Park, Kisoo
author_sort Lee, Yong Jig
collection PubMed
description We present two cases of paraplegic patients who developed secondary Raynaud’s phenomenon. A 43-year-old man with paraplegia presented with dark purple discoloration and skin defects on his left second and third toes and complained of a cold sensation in both feet for a period of 1 year. He had been taking diuretics for 4 years. The capillary refilling time for both affected toes was delayed. His antihypertensive drug was changed to a calcium channel blocker under suspicion of Raynaud’s phenomenon aggravated by hydrochlorothiazide, and the capillary refilling time normalized within 3 days. The toe skin defect was covered with a skin graft. A 51-year-old man with paraplegia presented with cyanotic color change and recurrent unstable wounds on his toes. He was also taking diuretics for hypertension. Suspecting secondary Raynaud’s phenomenon aggravated by diuretics, we changed the diuretics to olmesartan medoxmil 20 mg and amlodipine besylate 2.5 mg per day. Subsequently, he has had no unstable wounds for 30 months. If hypertensive patients with paraplegia complain of skin discoloration in their extremities, Raynaud’s phenomenon should be considered and the antihypertensive drug may need to be stopped in order to improve the wound-healing process.
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spelling pubmed-58031702018-02-14 Secondary Raynaud’s Phenomenon and Skin Necrosis of Toes in the Paraplegic Patient with Hypertension Lee, Yong Jig Park, Kisoo Drug Saf Case Rep Case Report We present two cases of paraplegic patients who developed secondary Raynaud’s phenomenon. A 43-year-old man with paraplegia presented with dark purple discoloration and skin defects on his left second and third toes and complained of a cold sensation in both feet for a period of 1 year. He had been taking diuretics for 4 years. The capillary refilling time for both affected toes was delayed. His antihypertensive drug was changed to a calcium channel blocker under suspicion of Raynaud’s phenomenon aggravated by hydrochlorothiazide, and the capillary refilling time normalized within 3 days. The toe skin defect was covered with a skin graft. A 51-year-old man with paraplegia presented with cyanotic color change and recurrent unstable wounds on his toes. He was also taking diuretics for hypertension. Suspecting secondary Raynaud’s phenomenon aggravated by diuretics, we changed the diuretics to olmesartan medoxmil 20 mg and amlodipine besylate 2.5 mg per day. Subsequently, he has had no unstable wounds for 30 months. If hypertensive patients with paraplegia complain of skin discoloration in their extremities, Raynaud’s phenomenon should be considered and the antihypertensive drug may need to be stopped in order to improve the wound-healing process. Springer International Publishing 2018-02-07 /pmc/articles/PMC5803170/ /pubmed/29417244 http://dx.doi.org/10.1007/s40800-018-0071-6 Text en © The Author(s) 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Case Report
Lee, Yong Jig
Park, Kisoo
Secondary Raynaud’s Phenomenon and Skin Necrosis of Toes in the Paraplegic Patient with Hypertension
title Secondary Raynaud’s Phenomenon and Skin Necrosis of Toes in the Paraplegic Patient with Hypertension
title_full Secondary Raynaud’s Phenomenon and Skin Necrosis of Toes in the Paraplegic Patient with Hypertension
title_fullStr Secondary Raynaud’s Phenomenon and Skin Necrosis of Toes in the Paraplegic Patient with Hypertension
title_full_unstemmed Secondary Raynaud’s Phenomenon and Skin Necrosis of Toes in the Paraplegic Patient with Hypertension
title_short Secondary Raynaud’s Phenomenon and Skin Necrosis of Toes in the Paraplegic Patient with Hypertension
title_sort secondary raynaud’s phenomenon and skin necrosis of toes in the paraplegic patient with hypertension
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5803170/
https://www.ncbi.nlm.nih.gov/pubmed/29417244
http://dx.doi.org/10.1007/s40800-018-0071-6
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