Raynaud's phenomenon

peripheral, which causes a reduction in blood flow to the involved regions. The reaction can be triggered by cold and / or emotional stress.

Raynaud's phenomenon occurs mainly in the fingers and toes, but can also involve the tip of the nose, earlobes, tongue and other parts of the body, where small blood vessels are more sensitive to temperature changes. During an episode, called a vasospastic attack, considerable pain may occur, associated with a burning, numbness, or tingling sensation. Raynaud's phenomenon is made evident by the change in skin color in the affected area, which can turn pale to cyanotic and eventually red when normal circulation is restored. In severe cases, ulcers and infections can arise in the area. Raynaud's phenomenon can be primary (without any associated disorder) or caused by other underlying conditions, such as scleroderma, rheumatoid arthritis, or systemic lupus erythematosus. Raynaud's secondary).

they begin to shrink and blood is diverted from the extremities to vital organs. Raynaud's phenomenon could, therefore, be considered as an "exaggeration of the body's natural response to (hypo) thermal stress.

The result of extreme vasoconstriction is a sharp decrease in the blood supply to the respective regions, which leads the tissue to hypoxia (severe lack of oxygen, a gas essential for cellular metabolism). Recurrent episodes can cause atrophy of the skin and tissues subcutaneous and muscle. In rare cases, ulceration and ischemic gangrene may result. Probably, Raynaud's phenomenon is caused by complex alterations in the balance between the chemicals that cause vasoconstriction and those that dilate or relax the capillary walls. Other mechanisms may include hyperactivity of the sympathetic nervous system or vascular damage. Sudden emotional or psychological disturbances can also induce a vasospastic attack.

: in the presence of low temperatures, the blood flow to the fingers or toes is markedly reduced, the skin becomes pale or white, cold and numb;

Cyanosis: when oxygen is deficient or exhausted, the affected area begins to turn bluish;

Redness: When the episode subsides or the area is heated, the skin takes on a bright red color, due to the compensatory increase in blood flow. Return of normal blood supply can cause tingling, numbness, and pain.

In most cases, Raynaud's phenomenon can interfere with patients' daily activities, but it does not cause any long-term damage to the extremities. Attacks can last from less than a minute to several hours. After warming up, it usually takes 15 minutes to restore normal blood flow to the affected area.

systemic.

Secondary Raynaud's phenomenon is particularly common in people with connective tissue diseases. The disease most likely to cause Raynaud's phenomenon is systemic sclerosis (also known as scleroderma), which can also occur in a localized form called CREST syndrome. The hallmark of the condition is thickening of the skin, especially on the hands and face. In these areas, dilations of blood vessels (telangiectasias) and deposits of calcium salts under the skin (calcinosis) may appear. In severe scleroderma, patients can develop persistent ulcers on the fingertips and infections, which in extreme cases can develop into gangrene.

Raynaud's phenomenon can also occur in patients with other connective tissue diseases, including Sjögren's syndrome, dermatomyositis, polymyositis, and Wegener's granulomatosis. Importantly, underlying connective tissue disease may not be evident until Raynaud's phenomenon occurs.

Medicines

Raynaud's phenomenon can be a side effect of some drugs, such as:

• Amphetamines;
• Certain types of beta blockers (mainly used for angina and hypertension);
• Some chemotherapeutic agents (vinblastine, bleomycin etc.);
• Some migraine medications containing ergotamine;
• Clonidine (for high blood pressure, migraines or hot flashes);
• Bromocriptine (used in the management of Parkinson's disease and some other conditions);
• Imipramine (for depression);
• Oral contraceptive pill.

Once the responsible drug is eliminated and replaced, Raynaud's phenomenon can resolve quite quickly.

Arteriopathy

Raynaud's phenomenon can sometimes indicate underlying atherosclerosis, especially in smokers. Buerger's disease can also lead to the onset of the disorder.

Nervous disorders

Raynaud's phenomenon can develop in a limb affected by a stroke or it can occur in association with multiple sclerosis and polio.

Various

Other possible causes of secondary Raynaud's phenomenon are:

• Occupation: Professional use of vibrating tools, such as pneumatic hammers or chainsaws, similar to repetitive blows with heavy hand tools, can cause traumatic vasospasm (known as hand-arm vibration syndrome); also chemical exposure to industrial processes of polymerization of vinyl chloride (plastics) can induce a disease similar to scleroderma, of which the Raynaud's phenomenon can be one manifestation.
• Carpal tunnel syndrome: The hand in question can become more sensitive to low temperatures and manifest Raynaud's phenomenon.
• Upper thoracic outlet syndrome (HRT).
• Some disorders of the thyroid gland: some diseases increase the viscosity of the blood and can cause Raynaud's phenomenon.
• Injuries: Previous injuries to the hands or feet, such as fractures, surgery, or frostbite, can lead to Raynaud's phenomenon.