Raynaud’s disease, or Raynaud’s phenomenon is a condition that affects the blood vessels in the extremities usually, the fingers and toes. It is characterized by occasional attacks, called vasospastic attacks, where the blood vessels in the fingers and toes narrow, when they are exposed to cold temperatures and emotional stress.There are two types of Raynaud’s disease, they are primary Raynaud’s disease and secondary Raynaud’s disease.There is no known cause for primary Raynaud’s phenomenon. Primary Raynaud’s disease is more common than the secondary form and often is so mild that the patient never seeks any medical attention. It is more of an annoyance. Secondary Raynaud’s phenomenon is a more complex and serious disorder.The most common cause of secondary Raynaud’s phenomenon is connective tissue disease. The condition most commonly occurs with other diseases such as scleroderma or lupus, it is also associated with Sjögren’s syndrome, dermatomyositis, and polymyositis,these diseases also reduce the blood flow to the fingers or toes by causing blood vessel walls to thicken and the vessels to constrict.People who operate vibrating tools, or have repeated trauma to an area, specifically vibrations such as those caused by typing or playing the piano can develop a type of Raynaud’s phenomenon.
Attacks of Raynaud’s phenomenon are caused by an over reactionof the body’s natural response to cold. When a person is exposed to cold, the body’s normal response is to decrease the loss of heat and preserve the core temperature. Blood vessels in the surface of the skin are called thermoregulatory vessels because they reactto changes in thetemperature. To maintain a normaltemperature, these specialized blood vessels in the skin surface constrict and move blood from arteries near the surface to veins deeper in the body.People who have Raynaud’s phenomenon the thermoregulatory vessels over reactto the coldwith intense spasmodic contractions of these small blood vessels that supply blood to the skin of the fingers, toes, ears, and face.When an attack starts, a person may experience three phases (though not all people have all three) of skin color changes – typically from white to blue to red – in the fingers or toes.
When an attack starts, a person may experience three phases of skin color change.Not all people experience all three of the skin color changes.Usually the skin will change colors from white to blue to red in the fingers or toes. Whiteness (called pallor) can occur in response to spasms of the arterioles which are small branches of an artery and is the result of the collapsing of the arteries supplying the fingers and the toes. Blueness (cyanosis) may appear because the extremities are not getting enough oxygen in the blood. Last, as the arterioles dilate, or relax and blood returns to the fingers and toes, redness (rubor) may be present.
During the attack, the fingers and toes will feel cold and numb as blood flow to them is reduced. As the attack draws to an end and blood flow returns, fingers and toes may throb and tingle. Usually the blood flow to the skin will remain low until the skin has warmed again. After warming, it only takes a few minutes to regain normal blood flow to the skin.
The treatment of primary Raynaud’s disease is to reduce the number and intensity of attacks and to prevent tissue damage. The treatment for patients with Raynaud’s phenomenon is mild becausethey do not get tissue damage. For these patients, doctors recommend non-drug treatments before moving onto prescription medications. For patients with secondary Raynaud’s phenomenon, treatment may be more aggressive and include medications.In the more serious cases, Raynaud’s causes ulcers and serious tissue damage that does not respond to medications. Doctors may choose a surgical procedure called a digital sympathectomy.This procedure may result in reducing symptoms and healing tissue, it only helps temporarily.