Raynaud’s disease

Raynaud’s disease

This idiopathic condition usually occurs in young women and a ff ects the hands more than the feet. There is abnormal sensi tivity in the arteriolar response to cold. These vessels constrict and the digits (usually the fingers) turn white and become incapable of fine movements. The capillaries then dilate and Mikito Takayasu , 1860–1938, Japanese ophthalmologist, described this disease in 1908. digits becoming swollen and dusky . As the attack passes o ff , the arterioles relax, oxygenated blood returns into the dilated capillaries and the digits become red. Thus, the condition is recognised by the characteristic sequence of blanching, dusky cyanosis and red engorgement, often accompanied by pain. Superficial necrosis is very uncommon. This condition must be distinguished from Raynaud’s syndrome, which has similar features (see Raynaud’s syndrome ). Treatment of Raynaud’s disease consists of protection from cold and avoidance of pulp and nail bed infection. Calcium antagonists, such as nifedipine, may also have a role to play and electrically heated gloves can be useful in winter. Sympathectomy has been used in the past but it is either ine ff ective or its e ff ects are short-lived.