Raynaud's Disease

"An idiopathic vascular disorder characterized by bilateral Raynaud phenomenon, the abrupt onset of digital paleness or CYANOSIS in response to cold exposure or STRESS."

When Raynaud's symptoms appear alone, without any other medical condition, it is called Raynaud's disease. It is also termed primary Raynaud's. In this condition, the blood vessels return to normal afterward. Primary Raynaud's usually affects both the hands and the feet.

Raynaud's Phenomenon

When Raynaud's symptoms have a specific cause or are accompanied by another disease, it is called Raynaud's phenomenon or secondary Raynaud's. This condition, which more often affects either the hands or feet, is often more serious and may result in blood vessel scarring and long-term consequences

Raynaud's phenomenon can be associated with diseases of the arteries such as Buerger's disease and atherosclerosis, rheumatoid arthritis, scleroderma and systemic lupus erythematosus. It can also follow repeated trauma, particularly vibrations such HAVS or those caused by typing or playing the piano.

An overdose of ergot compounds or methysergide may also be a cause of Raynaud's phenomenon.

Strong emotion or exposure to the cold causes the fingers, toes, ears or nose to become white, due to a lack of blood flow in the area. They then turn blue, which is a result of tiny blood vessels dilating to allow more blood to remain in the tissues. When the flow of blood returns, the area becomes red and then later returns to normal colour. There may be associated tingling, swelling, and painful throbbing. The attacks may last from minutes to hours.

If the condition progresses, blood flow to the area could become permanently decreased causing the fingers to become thin and tapered, with smooth, shiny skin and slow growing nails. If an artery becomes blocked completely, gangrene or ulceration of the skin may occur.

The risk factors include associated diseases and smoking. Women are 9 times more likely to be affected than men.

The condition can range in severity from minor discomfort to the onset of ulcers or even gangrene. The disease often starts in the very young or during the early teens and progresses slowly over a period of thirty years or more

Diagnosis

Generally diagnosis of Raynaud's Syndrome requires no special tests, although tests such as nail fold capillaroscopy (examining the nail fold under magnification to see capillary changes indicative of connective tissue disease); cold stimulation this involves submerging the hands in ice and then timing their return to normal colour. or a vascular laboratory assessment may be used to determine the severity of the disease.

Severity, duration, and frequency of attacks may vary between individuals and over time, the primary symptoms of Raynaud's Syndrome are changes in skin colour.: fingers and sometimes toes turn white, then blue, then red. The tip of the nose and the earlobes and (rarely) the cheeks or chin can also be affected. Sometimes the fingers perspire. Numbness accompanies the white and blue phases. The red phase brings a burning, throbbing, or tingling sensation and sometimes swelling.