As a young hospital pharmacist I often dispensed nitroglycerin tablets to relieve angina
(chest pain) caused by coronary artery disease. Later,as a physician internist I prescribed it both
while working in the emergency room and on the hospital floors.
Now,as a physician dermatologist, I am amazed at the many uses of this valuable
medication even when used topically(ie,not taken internally but applied to various parts of the outside
of the body.)
Nitroglycerin can be applied as an ointment to the skin where it again -as in the heart-
dilates or widens small blood vessels which have been vasoconstricted by various factors including
cold temperatures,emotions,hormones and even certain medications.In addition, autoimmune
diseases such as systemic lupus erythematosus and systemic sclerosis can also cause this
condition.
This vasosparm or constriction of the blood supply to body parts such as the fingers
and toes is called Raynaud's phenomenon. And,if your fingers or toes have ever been exposed to
freezing cold temperatures even for a short time,you know how discomforting it is and how fast
you have tried to rewarm them.
Pernio,also called chilblains,is an inflammatory response to cold on the hands and
feet and is characterized by itching,red patches and swelling and blistering.
Also,topical nitroglycerin ointment has been used in dermatology to treat small
tender nodules usually found on the outer rim of the ears (ie,the helix of the ear) which are
exquisitely sensive to pressure-especially when the patient lays on them in bed at night.
This condition is called chondrodermatitis nodularis helicis (literally inflamation of the ear
cartilage)
In addition,topical nitroglycerin ointment is also used to relieve the severe
pain caused by long term tears in the lining of the anal cavity,called anal fissures, by
reducing the pressure on them.
Two of the most common side effects of topical nitroglycerin include headaches
and dizziness,although this is even less likely with the 1 % formulation than with the
2 % product.
In summary, topical nitroglycerin may be a safe,inexpensive and effective
therapy wherever increased cutaneous blood flow is needed.
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