Raynaud’s disease is characterized by paroxysmal bouts (sudden debut), pallor and cyanosis (aubergine color the skin) located bilateral and symmetrical in the fingers, followed by erythema (redness). These accesses are too cold and emotional disturbances and improve the heat. Raynaud’s syndrome is characteristic especially young women.
Raynaud’s disease is the primary of the idiopathic (of unknown cause) form of paroxysmal crisis (sudden onset) of digital cyanosis. Raynaud’s phenomenon is more common than Raynaud’s disease and is secondary to local or systemic diseases. In Raynaud’s disease, digital arteries respond excessively to vasospastic stimuli (strong, brutal constriction of small vessels in the fingers and toes). The cause is unknown, yet nervous system abnormalities appear to be involved .
Diagnosis Of Raynaud’s Disease
In the early attacks of Raynaud’s phenomenon only 1-2 fingers may be affected . As the disease progresses all fingers will be affected. The thumb is rarely affected.
During the blood flow occlusion phase strong reddening, pulsed sensations, paresthesia (numbness) and an easy degree of edema (excessive accumulation of fluid in tissues) appear. These accesses usually stop spontaneously or after entering a heated room. Also, Raynaud’s crisis can be relieved by placing hands in warm water.
This condition progresses to atrophy (a pause in the normal development) and finger pulp skin at this level, together with the appearance of gangrenous ulcers. The lesions heal in hot weather.
Raynaud’s disease begins between 15 and 45 years, affecting almost always women. It has a progressive evolution compared with the Raynaud’s phenomenon (which may be unilateral and may involve only one or two fingers), affecting the fingers of both hands symmetrically. Over time, the spasms are becoming more frequent and prolonged.
The of Raynaud’s disease is established when the phenomena persist for more than three years without apossible cause that could be highlighted. There are no specific laboratory changes and the diagnosis is established after the clinical examination. To exclude other diseases associated with Raynaud’s phenomenon, further investigation is required.
The Treatment Of Raynaud’s Disease
- The patient must be kept at a warm temperature and his hands must be especially protected from cold; the patient must wear gloves during the cold seasons;
- Hands should be permanently protected from blows because wounds heal slowly and, consequently, infections are difficult to control;
- Patient with this disorder often will apply emulsifier and moisturizer lotions for dry and cracked skin;
- Patients who smoke should quit smoking because their condition can get much worse.
Vasodilator drugs have limited effects, as indicated in patients who have not achieved effective control of disease by general means and also in cases where peripheral vasoconstriction is not accompanied by significant organic changes.
For a faster normalization of temperature of the areas affected the patient must use transdermal nitroglycerin or other similar medicine with long-acting time.
Sympathectomy (surgical cutting of one or more sympathetic nerves) is indicated if the phenomena are very frequent and severe, interfering with daily activities and individual comfort. Surgery is also indicated when trophic changes occur and medical measures have failed.