Raynaud's phenomenon ( Raynaud's disease , Raynaud's syndrome) - Causes, Symptoms and Treatment .MF .
Raynaud's phenomenon - it is significantly expressed reaction of the small blood vessels of the fingertips to exposure to cold or psycho-emotional shock.
disease is based on a violation of the nervous regulation of vascular tone, resulting in a response to external stimuli occurs persistent narrowing of the small blood vessels.The disease is most common in young adults.Women suffer many times more often than men.
Causes of Raynaud's phenomenon
Allocate primary Raynaud's phenomenon, or Raynaud , which occurs independently and is found in 90% of cases (the reasons for its not known for certain, an important predisposing factor is considered due to hereditary characteristics of vascular response to various external circumstances), andsecondary Raynaud's phenomenon, Raynaud's syndrome or , which is a complication of systemic diseases such as systemic scleroderma, systemic lupus erythematosus.In addition, Raynaud's syndrome is developing in lesions of the cervical spine, peripheral nervous system, the
symptoms of the disease and Raynaud's syndrome
In the course of the disease are three stages:
• angiospastic .For this stage is characterized by paroxysmal vasoconstriction, accompanied by clinical symptoms, followed by periods of complete well-being.When disease or Raynaud's syndrome early in the disease, usually affects the blood vessels of the fingers.A characteristic symptom of the disease at the time of the attack is a succession of skin color under the influence of cold or emotional stress.At the beginning of the attack the skin becomes pale, cold to the touch after a while due to an eating disorder, it acquires a bluish color.
blanching of fingers when Raynaud's phenomenon
attack lasts several minutes.Then, the blood flow is restored, there is a warming and pinkness of the skin.At the same time, patients may complain of more or less severe pain in this area.After some time, the skin becomes discolored, which is maintained until the next attack.After the attack in many patients a feeling of coldness, tingling, and numbness in the fingertips, which after some time pass.In the early stages of the disease symptoms are recorded only in one or more fingers of the hand, after the lesion extends to all the fingers hands, feet and tip of the nose, ears and lips.
Very often Raynaud's disease is stopped at this stage, while the syndrome of Raynaud's usually develop more dramatic consequences.
• Angioparaliticheskaya stage .At this stage, the attacks are becoming more prolonged, blue and numb fingers can take several hours.
Cyanosis end phalanges
fingers During this time, patients complain of pain significantly expressed in the fingertips.Due to impaired blood flow appears swollen fingers.Persistent vasoconstriction leads to disruption of supply of tissues, which manifests itself in the formation of small bubbles, the site of which subsequently formed small scars.
first and second stage of the syndrome of Raynaud lasts on average 3-5 years.
• Trofoparaliticheskaya stage .The final stage of the disease, characterized by profound malnutrition surrounding tissues.On the fingertips arise nonhealing ulcer foci of necrosis of tissue, upon accession infection develops gangrene.
ulcer final phalanx II fingers in the syndrome of Raynaud
necrosis end phalanges of fingers with Raynaud's syndrome
Often all three stages of Raynaud's phenomenon can be found in one person, including the neighboring fingers of onearms.
symptoms similar to the symptoms of Raynaud's disease, observed in diseases of the endocrine glands, nervous system, weakening of the immune system, as well as chronic poisoning with salts of lead and mercury, prolonged exposure to vibration.In these cases, vascular disorders may be one of the first and most important symptoms, so you should not engage in self-diagnosis, consult a physician in identifying at the above symptoms.
survey's disease and Raynaud's syndrome
The diagnostic plan is very important to distinguish between Raynaud's phenomenon and Raynaud's disease.The following diagnostic criteria are marked for Raynaud's disease:
• symmetrical loss of fingers;
• absence of other vascular disease;
• lack of persistent malnutrition surrounding tissues (necrosis, ulceration, gangrene);
• no destruction of the capillaries of the nail bed;
• lack of laboratory parameters specific for systemic diseases (antinuclear antibodies, accelerated ESR).
diagnosis of disease or Raynaud's syndrome is reliable in detecting phase (pallor, cyanosis, redness) changes in skin coloration last phalanges at attacks.In other cases, the diagnosis is conjectural.In the presence of certain connective tissue diseases (systemic scleroderma, systemic lupus erythematosus) diagnosis of Raynaud's syndrome becomes more likely.
To determine the condition of the nail bed capillaries used Capillaroscopy.
Image normal capillary nail bed, resulting from the Capillaroscopy.Increased 175 times
With the help of a microscope the doctor evaluates the capillaries of the skin folds of the nail bed.painless method, additional training to the study is not required.
To simulate an attack and identify with the changes in skin color is carried out cold test.the patient's arm for 2-3 minutes immersed in water with a temperature of 10 ° C and observe the state of the skin over time.
Treatment of Raynaud's disease
Today you can if you do not heal completely, then slow down the progression of Raynaud's disease.Treatment of the disease is carried out by a rheumatologist.General recommendations are mainly aimed at lifestyle changes and include the following provisions:
• should avoid prolonged stay in cold places.Recommended wearing, save heat (gloves, hat, warm underwear).
• stopping smoking, drinking caffeine containing drinks - obligatory component of successful treatment.
• to avoid emotional stress, as well as to refrain from taking drugs that have a stimulating effect on the nervous system (sympathomimetics, clonidine and others).
• avoid exposure to vibration (grinder, blender, etc.);refrigerator, washing machine put on a rubber mat to soften the vibration.
First Aid fit
When an attack is recommended to take steps to warm the hand: put your hands in warm water, squeeze in the armpits, rub fingertips, perform a circular motion in the joints of the hand.Typically, these activities allow you to restore vascular tone.
Drug treatment of disease and Raynaud's syndrome
For the treatment of the disease is now widely used vasodilators and antiplatelet agents (preventing platelets from sticking together and forming blood clots).From vasodilators are the most common calcium channel blockers (nifedipine, amlodipine).As used antiplatelet agent pentoxifylline.In the case of ulcers infection, the appearance of foci of necrosis, surgical treatment.
When Raynaud's disease prognosis is favorable, as the persistent malnutrition tissue formed very rarely.In Raynaud's syndrome nature of the disease and the impact on the patient's quality of life is generally defined underlying disease.
first bouts of the disease may occur after an infection or exposure to precipitating factors - fatigue, hypothermia, excessive sunbathing.The development of Raynaud's disease is possible as a result of a brain injury or severe emotional distress.In favor of the neurological nature of the disease and said symmetrical lesions: manifestations of the disease almost simultaneously capture the same portions of the right and left.But a certain importance and exercise on your fingers - the disease occurs more often in secretaries pianists.Avoid the above risk factors, even a healthy person.
therapists Sirotkin EV