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To the Editor:—
We are grateful to Drs. Gifford and Hines for their comments on our paper. Their group has studied Raynaud's phenomenon for many years. Actually, when one studies their carefully documented papers, with which we are well familiar, one finds considerable data disproving their, and confirming our, contention. Thus, in 12% of their patients, trophic lesions occurred after sympathectomy. In one, the case reports, "Raynaud's disease" was present for 23 years before stellate ganglionectomy. Six years after the operation, ulceration of fingers developed "in spite of complete denervation."These authors do recognize that secondary Raynaud's phenomenon shows poor results from sympathectomy in 72% of the cases; 35% of them were dead at the time of follow-up.The crux of the situation in our view, is whether or not one is capable of differentiating Raynaud's disease with sclerodactylia from early diffuse scleroderma with Raynaud's phenomenon. One is, of course,
Takats GD. Raynaud's Phenomenon-Reply. JAMA. 1962;180(8):703. doi:10.1001/jama.1962.03050210064025
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