Raynaud's Disease Phenomenon
Raynaud's Disease Phenomenon Causes
The actual cause of Raynaud's disease is, as yet, unknown. However, emotional stress and exposure to extreme cold are common triggers. Nicotine is also known to worsen the frequency and intensity of the attacks. Additionally, a hormonal component is suspected. Currently, clinical research points to a hereditary cause, but no sufficient evidence has been found to date.
Raynaud's Disease Phenomenon Definition
Raynaud's phenomenon, or Raynaud's disease, is a vasospastic disorder characterized by a discoloration of the fingers, toes, and occasionally other extremities. Named after 19th century French physician Maurice Raynaud, Raynaud's disease occurs more commonly in women than in men. When Raynaud's disease occurs without any underlying associated disease, it is known as primary Raynaud's (or simply, Raynaud's disease). If it appears as part of another disease, it is known as secondary Raynaud's or Raynaud's phenomenon.
Raynaud's Disease Phenomenon Diagnosis
If Raynaud's disease is suspected, a clinical screening for known symptoms often helps in diagnosis. A physician may perform a cold-simulation test (for example, placing a patient's hand in cool water or exposing the patient to cold air) to invoke a Raynaud's attack. Although simple screening for diagnostic symptoms can lead to diagnosis, it is much more difficult to identify underlying conditions in secondary Raynaud's. To identify Raynaud's as primary or secondary, a physician may perform a nail fold capillaroscopy, in which the patient's nail fold is examined under a microscope. Deformed or enlarged capillaries near the nail fold often indicate an underlying disorder.
Raynaud's Disease Phenomenon Symptoms and Signs
Raynaud's disease presents with pale, painful, and cold extremities. For undiagnosed patients exposed to an extremely cold climate, the disease can be potentially lethal. Raynaud's disease is primarily a disorder of the blood vessels that supply blood to your skin. During an attack, these arteries narrow, thus limiting blood circulation to affected areas. Symptoms include visible changes in the color of your skin as a response to cold or stress. Often, it also manifests as a stinging sensation or a numb, prickly pain upon warming or relief of stress. Patients with secondary Raynaud's may also exhibit symptoms characteristic of the underlying disorder.
Raynaud's Disease Phenomenon Treatment
Treatment for Raynaud's disease is focused on preventing or managing further episodes. General measures include avoiding environmental triggers (such as cold air and vibration), covering the extremities with warm clothing, hormone regulation, and smoking cessation. Drug treatment commonly includes calcium channel blockers to open up the blood vessels in the extremities as well as decrease the severity and frequency of the attacks. Alpha blockers are also used to counteract norepinephrine, a hormone that constricts blood vessels. Some physicians also prescribe vasodilators to help relax the blood vessels. When the disease persists, surgical intervention in the form of sympathectomy and prostaglandins infusions may be necessitated. Very rarely, amputation may be needed to control extremely severe attacks.