Normally when our body is exposed to called weather, vasoconstriction of the peripheral blood vessels occurs. So the heat loss from the body is minimized. When this reaction is exaggerated, it leads to Raynaud phenomenon. It is classified clinically into primary or secondary forms. Primary disease occurs without any association with other disease or pathology where as secondary disease always has another underlying disease.
Diseases which have Raynaud phenomenon as one of their symptoms
- Scleroderma
- Systemic Lupus Erythematosus
- Other connective tissue disorders
- Hematologic disorders (eg: cryoglobulinaemia)
- Vibration injury
- Endocrine disorders (e.g.: hypothyroidism)
- Some drugs (e.g.: sympathomemetics)
Symptoms and Signs
Mostly the fingers are affected (mainly middle, index and ring fingers), but it can also occur in toes and face. Each attack has a characteristic sequence of events.
- Sudden onset of coldness or pallor of digits (white attack)
- Cyanosis (Blue attack)
- Redness from reperfusion
Diagnosis Criteria for Primary Raynaud Phenomenon
- Symmetrical intermittent attacks
- No evidence of peripheral vascular disease can be found
- No tissue gangrene or digital pitting
- Nail fold capillary microscopy is normal
- ANA antibody test is negative and ESR is normal
Treatment
- Preventive strategies
- Vasodilator Therapy
- Nitrates and Other Topical Therapy
- Prostaglandins/Endothelin-Receptor Inhibitors
- Calcium Channel Blockers
- Angiotensin-Converting Enzyme Inhibitors
- Phosphodiesterase Inhibitors
- Sympatholytic Agents
- Sympathectomy
- Selective Serotonin Reuptake Inhibitors
- Anticoagulation
References: Rheumatology Current Diagnosis and Treatment
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