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Raynaud’s Disease

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There are many disorders and conditions that affects people around the world. One such disorder is Raynaud’s disease. This condition affects the extremities of the body. Thus, patients suffer from change in color of the fingers and toes.

What is Raynaud’s Disease?

Raynaud’s disease is also referred to as ‘Raynaud’s phenomenon’. When one develops the condition as a result of some other condition it is called as ‘Raynaud’s phenomenon’ or ‘secondary Raynaud’s phenomenon’. If the disease occurs on its own accord, it is called as ‘Raynaud’s disease’ or ‘primary Raynaud’s phenomenon’.

Raynaud’s disease is a condition that causes over-sensitivity of the small blood vessels in the body extremities to changes in temperature. It mostly affects women. However, it is commonly observed in all age groups, that is, children, adolescents and adults, who live in regions of cold climates.

The disease affects body extremities like fingers, toes, tip of the nose, chin, cheeks, ears. The small blood vessels in these parts constrict after being exposed to cold or hot temperatures. At times, this happens even during extreme changes in emotions. The constriction causes decrease in blood supply to the local tissues, leading to discoloration.

The patients may first complain of fingers and toes turning white. If the construction continues for a long time, the extremities may turn blue, due to prolonged lack of oxygen. Once the construction is released and  the blood supply resumes, the affected part may turn red, due to ‘flushing’.

Causes

Raynaud’s disease or Raynaud’s phenomenon, both have different causes. Let us have a look at their  distinguishing causes:

Primary Raynaud’s Phenomenon

Raynaud’s disease is usally idiopathic in nature, that is, there is no known cause for its occurance. This disease occurs on its own and is not associated with any other underlying condition. It can be considered hereditary to some extent, but mostly referred to as an allergy to cold temperature. Hormonal imbalance, caffeine as well as smoking tends to increase the frequency and severity of the disease.

Secondary Raynaud’s Phenomenon

Raynaud’s phenomenon usually occurs as a result of many different disorders and conditions. These underlying disorders that can lead to discoloration of body extremities due to constriction of blood vessels include:

  • Connective tissue disorder like rheumatoid arthritis, systemic lupus erythematous
  • Hormonal imbalance like hypothyroidism
  • Trauma like frostbite
  • Obstructive disorders of the arteries like atherosclerosis
  • Eating disorders
  • Use of certain drugs like beta-blockers, sulfasalazine, etc.
  • Multiple sclerosis
  • Carpal tunnel syndrome
  • Lyme disease
  • Erythromelalgia
  • Scleroderma
  • Exposure to mercury, etc.

Symptoms

The symptoms of Raynaud’s disease are not similar to the symptoms of frostbite. The condition causes extreme pain in the affected part. Other symptoms include:

  • The skin in the affected part becomes white or pale.
  • Extremities affected feel cold and numb.
  • As the oxygen supply continues to drop, one develops cyanosis, that is, blue coloration in the affected part.
  • When blood flow resumes, the skin becomes red, then turns normal after some time.
  • The patient may complain of swelling, pain, ‘pins and needles’ as well as tingling in the affected as it starts coming back to its normal color.
  • One should also note, that not all develop the three colorations and it is not necessary to develop the colorations in the same order.

Diagnosis

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The patient is evaluated for the presence of other conditions by taking a detailed medical history. This will help decide, if the condition is primary or secondary. Some of the tests carried out include:

  • Antinuclear antibodies test
  • Erythrocyte sedimentation rate
  • Blood urea test
  • Thyroid function test
  • Doppler ultrasound
  • Digital artery pressure, etc.

Treatment

There is no cure for Raynaud’s disease. The treatment usually involves keeping oneself warm enough at all times, during winter. One is advised to wear warm socks and gloves at all times. Certain medications may be prescribed to relieve the symptoms like:

  • Calcium channel blockers
  • Vasodilators
  • Chemical injections that block the sympathetic nerves in the extremities

At times, nerve surgery is required to cut certain blood vessels that are prone to contractions. This surgery is called as sympathectomy, that helps reduce the frequency of attacks to some extent. In some cases, decrease in blood supply for a long time results in tissue damage. This damage can lead to gangrene in extreme cases, that requires amputation of the affected part.

Prognosis

Prognosis for Raynaud’s disease is usually good depending on the severity of the other conditions associated with it. Patients usually do well with a little self-care, that is, keeping their bodies warm and covered during cold climate.

Avoid smoking as it causes constriction of blood vessels. It is important to recognize certain activities that trigger an attack. Once Raynaud’s disease is understood by the patient, the attack frequency can be minimized to a great extent.

Written by: Saptakee sengupta
Date last updated: February 25, 2015