Thursday, December 16, 2010

Raynaud's Disease




Thanks to modern technology (iphone) a picture is worth a thousand words in diagnosing a condition.  This young woman had been exercising outside by the Golden Gate Bridge in San Francisco (temp a chilly 49º F) and when she finished her hand looked like this.  It felt numb and began stinging when she ran hot water on it.

What is seen is classic Raynaud's disease.  It is a condition that causes some ares of the body like the fingers, toes, tips of nose and ears to have limited blood circulation in response to cold temperatures.  It affects women more than men and the skin can turn blue or white or purple in blotchy areas.  It is common to feel swelling and stinging as the circulation improves (such as immersing in hot water).  An attack can last several minutes to hours.

With Raynauds, there is a vasospasm of the small blood vessels that go to the digits.  This limits blood supply which causes the skin to turn pale.  Cold temperatures are most likely to trigger an attack but emotional stress can also cause it.  We think it is an inherited disorder.

Most of the time, Raynaud's does not require treatment.  Patients learn to avoid sudden cold (like refrigerators) and to wear gloves when it is cold outside.   If the attacks are frequent or severe, medications that dilate the blood vessels can be prescribed.  These are medications like nifedipine, amlodipine and felodipine.

The iphone saved her from a visit to the emergency department (where it is likely the vasoconstriction would have already resolved) or the office.

This is a form of "telemedicine". 

(Photo used with permission and gratitude)


17 comments:

Daisy said...

Thanks, Dr. T. I suspected that I have this from the ways my fingers are after being in the cold. Seeing this picture and hearing your description makes me sure of it. My father had it too.

I think my treatment will be to live with it for a few years and then move south where it is warmer when we retire (I hope)! :)

tracy said...

Hey, Daisy, i have it too. i wonder how common it is.... cute Christmasy pic!

i found out, like a hundred years ago, when i was at the OBGYN and he noticed what was happening to my fingers and toes....cold office...?

KM said...

Dr.Brayer, do you know why the ring finger doesn't seem to be affected like the surrounding fingers are in this pic?

Anonymous said...

Amazing photo. I too think I have Raynauds as I get some blue splotches on my hands in the cold. Thanks so much for the info.

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