What are the symptoms of Raynaud's disease?

Raynaud's syndrome is a disease that occurs when it is relatively cold or when the human body's mental and emotional fluctuations occur. Symptoms include whitening or redness of the skin on the fingers or toes. It is generally common in middle-aged and elderly people and young people, especially in winter or cold environments. It can cause numbness and pain in the fingers or toes, and the skin may also be prone to ulcers and other symptoms.

Causes

1. The cause of idiopathic Raynaud's syndrome is unknown and may be related to the following factors

(1) Cold stimulation: Patients are more sensitive to cold stimulation, and the incidence of this disease is higher in cold areas.

(2) Most patients with nervous excitement are of the sympathetic nervous system type, which may be related to central nervous system dysfunction and sympathetic nervous system hyperfunction.

(3) Occupational factors: Workers who work with vibrating machinery for a long time, such as pneumatic hammer operators, have an incidence rate as high as 50%, and the specific mechanism is unclear.

(4) Endocrine disorders: 70% to 90% of women suffer from this disease. Symptoms worsen during menstruation and improve during pregnancy, which may be related to sex hormones.

(5) Other causes: genetics, fatigue, infection, etc.

2. Secondary Raynaud's syndrome is often accompanied by the following diseases

(1) Systemic scleroderma;

(2) Systemic lupus erythematosus;

(3) dermatomyositis or polymyositis;

(4) Rheumatoid arthritis;

(5) Atherosclerosis of the limbs in patients over 50 years old;

(6) Thromboangiitis vasculitis, rare;

(7) Primary pulmonary hypertension.

Trauma and drugs such as ergot inducers, vincristine, barbituric acid, etc. can also cause this disease.

Clinical manifestations

It mostly occurs between the ages of 20 and 40, and is more common in women than in men. The onset is slow, starting in winter and lasting for a short time, gradually developing when exposed to cold or emotional excitement. It usually occurs symmetrically on the fingers of both hands and may also occur on the toes.

During an attack, the hands and feet become cold, numb, and occasionally painful. In a typical attack, the fingers become cool, pale, purple, and then flushed, with the metacarpophalangeal joints as the boundary. In the late stages of the disease, the hair on the back of the fingers gradually disappears, the nails grow slower, become rough, and deformed, the skin shrinks, becomes thinner and tighter (scleroderma fingers), ulcers form on the fingertips or around the nail beds, and may cause infection.

examine

1. Cold water test

Placing fingers or toes in 4 degrees Celsius cold water for one minute can induce the above typical symptoms.

2. Fist test

Clenching your fists for one minute and then releasing them while they are bent can also induce the above symptoms.

3. Skin UV irradiation experiment

The skin's erythematous response to UV radiation is reduced.

4. Finger artery angiography

If necessary, upper limb artery angiography can be performed to understand the condition of the finger arteries, which will aid in diagnosis.

diagnosis

The diagnosis of Raynaud's syndrome mainly relies on medical history and manifestations during typical attacks, combined with the above-mentioned provocative tests. Raynaud's syndrome should be distinguished between primary and secondary Raynaud's syndrome, and related diseases should be treated promptly.

treat

1. General treatment

Avoid exposure to cold environments and keep the distal extremities warm. Quit smoking.

2. Medication

(1) Calcium channel blockers: nifedipine and diltiazem.

(2) Reserpine.

(3) α receptor antagonists such as prazosin.

3. Surgery

Sympathectomy may be considered for those who do not respond to drugs, but its efficacy needs further observation.