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Jaanakhi VM, Ram B, Qureshi MJ, Jain M, Sawale S. Erasmus Syndrome: A Case Series of Rare Co-Occurrence of Silicosis and Systemic Sclerosis. Indian J Occup Environ Med 2022; 26:285-288. [PMID: 37033751 PMCID: PMC10077723 DOI: 10.4103/ijoem.ijoem_362_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 02/05/2022] [Indexed: 12/24/2022] Open
Abstract
Erasmus syndrome is the association of silica exposure and subsequent development of systemic sclerosis. Here we discuss five cases that presented with progressive shortness of breath, arthralgia, skin tightening, and Raynaud's phenomenon. History of exposure to silica dust was present in all cases, and further serological (Anti-Scl-70 antibody positive), radiological, and histopathological (skin biopsy) investigations confirmed the diagnosis of systemic sclerosis. Hence the diagnosis of Erasmus syndrome was made. Therefore, careful screening should be done in patients of silicosis with systemic symptoms to rule out any associated connective tissue disorder. Timely diagnosis and early intervention can prevent the patients from developing life-threatening complications and improved quality of life.
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Affiliation(s)
- V M Jaanakhi
- Department of Respiratory Medicine, Institute of Respiratory Diseases, SMS Medical College, Jaipur, Rajasthan, India
| | - Batoee Ram
- Department of Respiratory Medicine, Institute of Respiratory Diseases, SMS Medical College, Jaipur, Rajasthan, India
| | - Mohammad Javed Qureshi
- Department of Respiratory Medicine, Institute of Respiratory Diseases, SMS Medical College, Jaipur, Rajasthan, India
| | - Manisha Jain
- Department of Respiratory Medicine, Institute of Respiratory Diseases, SMS Medical College, Jaipur, Rajasthan, India
| | - Sumeet Sawale
- Department of Respiratory Medicine, Institute of Respiratory Diseases, SMS Medical College, Jaipur, Rajasthan, India
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Dhaliwal K, Griffin MF, Salinas S, Howell K, Denton CP, Butler PEM. Optimisation of botulinum toxin type a treatment for the management of Raynaud's phenomenon using a dorsal approach: a prospective case series. Clin Rheumatol 2019; 38:3669-3676. [PMID: 31482318 DOI: 10.1007/s10067-019-04762-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 08/09/2019] [Accepted: 08/22/2019] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Raynaud's phenomenon (RP) is a common condition and causes pain, paraesthesia, ulceration and gangrene. Botulinum toxin A (Btx-A) is effective when injected via a digital palmar approach, in the treatment of severe RP. However, hand weakness resulting from lumbrical malfunction is a recognized complication. This study aimed to determine the effect of Btx-A injected via a dorsal approach. METHOD Forty patients received 100 units of Btx-A, injected across both hands via a dorsal approach. Each patient had a baseline, 6- and 12-week hand assessment and thermographic image (FLIR E60bx) performed for the study. RESULTS Eighty-eight percent of patients reported an improvement in symptoms including reduction in pain, improved colour change with reduced swelling and edema at 6 weeks. Of these patients, 80% reported an improvement in cold intolerance with a reduction in the frequency and severity of Raynaud's attacks. There was a significant improvement in both the DASH score (p = 0.001), Kapandji score (p = 0.001) and hand strength (p < 0.05). No patients reported weakness. Improvements in hand function and symptoms of RP were still evident at 12 weeks. CONCLUSIONS Btx-A injected via a dorsal approach improves symptoms and reduces the number of RP. We have shown an effective non-surgical approach technique to treat RP.Key Points• Raynaud's phenomenon is a common vasospastic disorder of the digital vessels, which can cause severe pain, restrictions to hand function and ulceration.• Dorsal botulinum toxin type A injections can improve the symptoms of secondary Raynaud's phenomenon and hand function for approximately 3 months.
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Affiliation(s)
- Kiran Dhaliwal
- Charles Wolfson Center for Reconstructive Surgery, Royal Free Hospital, London, UK.,UCL Centre for Nanotechnology and Regenerative Medicine, London, UK.,Division of Surgery & Interventional Science, University College London, London, UK.,Royal Free Hospital, London, UK.,Plastic & Reconstructive Surgery, Royal Free Hospital, London, UK
| | - Michelle F Griffin
- Charles Wolfson Center for Reconstructive Surgery, Royal Free Hospital, London, UK. .,UCL Centre for Nanotechnology and Regenerative Medicine, London, UK. .,Division of Surgery & Interventional Science, University College London, London, UK. .,Royal Free Hospital, London, UK. .,Plastic & Reconstructive Surgery, Royal Free Hospital, London, UK.
| | - Sebastian Salinas
- Charles Wolfson Center for Reconstructive Surgery, Royal Free Hospital, London, UK.,UCL Centre for Nanotechnology and Regenerative Medicine, London, UK.,Division of Surgery & Interventional Science, University College London, London, UK.,Royal Free Hospital, London, UK.,Plastic & Reconstructive Surgery, Royal Free Hospital, London, UK
| | - Kevin Howell
- Charles Wolfson Center for Reconstructive Surgery, Royal Free Hospital, London, UK.,Royal Free Hospital, London, UK.,Center for Rheumatology, UCL Division of Medicine and Royal Free London NHS Foundation Trust Hospital, London, UK
| | - Christopher P Denton
- Charles Wolfson Center for Reconstructive Surgery, Royal Free Hospital, London, UK.,Royal Free Hospital, London, UK.,Center for Rheumatology, UCL Division of Medicine and Royal Free London NHS Foundation Trust Hospital, London, UK
| | - Peter E M Butler
- Charles Wolfson Center for Reconstructive Surgery, Royal Free Hospital, London, UK.,UCL Centre for Nanotechnology and Regenerative Medicine, London, UK.,Division of Surgery & Interventional Science, University College London, London, UK.,Royal Free Hospital, London, UK.,Plastic & Reconstructive Surgery, Royal Free Hospital, London, UK
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Misra DP, Chowdhury AC, Phatak S, Agarwal V. Scleroderma: Not an orphan disease any more. World J Rheumatol 2015; 5:131-141. [DOI: 10.5499/wjr.v5.i3.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 05/24/2015] [Accepted: 07/14/2015] [Indexed: 02/06/2023] Open
Abstract
Scleroderma (or systemic sclerosis) is a rare disease associated with significant morbidity and mortality. Although previously thought to have a uniformly poor prognosis, the outlook has changed in recent years. We review recent insights into the pathogenesis, clinical features, assessment and management of scleroderma.
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