Raynauds Disease
Description
A rare disease of the blood vessels called arteries, usually involving the fingers, toes and nose. The small arteries in this disorder narrow when exposed to cold temperature. This decreases blood flow to the affected body part causing it to turn white and blue. The artery then returns to normal, blood flow returns and the area turns red and throbs. In severe cases the decreased blood flow can cause ulcers and death of the tissue. There are two types of Raynauds primary and secondary. Primary Raynauds occurs without any other associated disease. Secondary Raynauds, also called Raynauds phenomenon, is caused by another disease usually an auto immune disorder such as Lupus, scleroderma, or Rhematoid arthritis. The cause of Primary Raynauds is not known but it is more common in women and in people from cold climates.
Symptoms
Symptoms vary but include: cold fingers and toes, white to blue skin discoloration when exposed to cold, numbness when exposed to cold. When circulation returns patients experience pins and needles, swelling, throbbing, and redness. Stress can cause similar changes as cold.
Tests
A history and physical exam will be done. The healthcare provider may perform a simple test called a cold-stimulation test. This test involves placing the hands in cool water or exposing to cold air, to trigger an episode of Raynaud's. If there is a suspicion of secondary Raynauds other tests may be done to diagnose the secondary disease.
Treatment
Therapy depends on the severity of the symptoms. Avoiding cold exposure to the affected body part is simply all that is needed in some patients. Medications are sometimes used including: nifedipine (Adalat CC, Procardia), amlodipine (Norvasc), felodipine (Plendil), prazosin (Minipress), doxazosin (Cardura), and nitroglycerin. Surgery or injection of a sclerosing agent to remove the sympathetic nerve stimulus can be performed in severe cases. Patients with Raynauds should avoid over the counter pseudoephedrine (Actifed, Chlor-Trimeton, Sudafed), beta blocker medications, and birth control pills.
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