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Raynaud's Phenomenon

It is a vasospastic disorder causing discoloration of the fingers, toes and occasionally other areas. It is a condition that leads to brittle nails with longitudinal ridges. Raynaud's phenomenon includes Raynaud's disease (also known as "Primary Raynaud's phenomenon") where the phenomenon is idiopathic.

Raynaud's phenomenon is an exaggeration of vasomotor responses to cold or emotional stress. Specifically, it is a hyperactivation of the sympathetic nervous system causing vasoconstriction of the peripheral blood vessels, leading to tissue hypoxia. Chronic, recurrent cases of Raynaud's phenomenon can result in atrophy of the skin, subcutaneous tissues, and muscle. In rare cases it can cause ulceration and ischemic gangrene.

References: www.nhs.uk
www.nlm.nih.gov
www.nhlbi.nih.gov

The condition can cause pain within the affected extremities, discoloration (paleness), and sensations of cold and numbness. These changes to the skin usually happen in three stages:

  • Stage one: The affected body part turns white because blood supply is restricted
  • Stage two: It then turns blue due to lack of oxygen during this phase the body part can feel cold and numb
  • Stage three: The body part turns red as the blood returns at a higher rate than normal during this stage, there is tingling or throbbing sensation, and there may be some swelling in the affected body part.

Reference: www.nhs.uk

Raynaud's phenomenon is the result of over-sensitive blood vessels in the body's extremities. In many cases, no cause is identified, although it is sometimes linked to other health conditions.

Primary Raynaud's: The most common form of Raynaud's phenomenon occurs by itself, without being associated with another health condition.

Secondary Raynaud's: In some cases, there is an underlying reason, associated with a health condition, that causes the blood vessels to overreact. This is called secondary Raynaud's.

  • Autoimmune conditions
  • Infections
  • Cancer
  • Injury due to overuse

Reference: www.nhs.uk
 

Medical history taking by physician will often reveal whether the condition is primary or secondary. Once it is established, an examination is largely to identify possible secondary causes of Raynaud's phenomenon.

  • Digital artery pressure: Pressures are measured in the arteries of the fingers before and after the hands have been cooled. A decrease of at least 15 mmHg is diagnostic (positive).
  • Doppler ultrasound: To assess blood flow.
  • Full blood count: This reveal a normocytic anemia suggesting the anemia of chronic disease or renal failure.
  • Antinuclear antibodies (ANA) test:This blood test checks for antinuclear antibodies in blood. These antibodies are produced by  immune system and attack body's own tissues.
  • Erythrocyte sedimentation rate:This blood test measures how fast red blood cells settle to the bottom of a test tube. A faster-than-normal fall rate can indicate an autoimmune disorder.

Reference: www.nhlbi.nih.gov
 

It is mainly managed by managing the trigger factors in case of primary Raynaud's. Secondary Raynaud's can be treated by treating its underlying courses.

Drug therapy: Treatment for Raynaud's phenomenon may include prescription medicines such as calcium channel blockers (nifedipine) or diltiazem.

Reference: www.nhs.uk
 

People with Raynaud's phenomenon have an increased risk of developing problems, such as scleroderma.

Scleroderma: It is a condition in which body produces excessively high levels of collagen.

  • CREATED / VALIDATED BY : NHP CC DC
  • LAST UPDATED ON : Oct 29, 2015

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