The human body has features that enable it to adapt to the temperature changes occurring in its environment. The decrease in blood flow to the skin to prevent heat loss with a decrease in ambient temperature or the expansion of vessels when the ambient temperature increases can be given as examples of adaptation mechanisms that occur in the body as a result of temperature changes.
What is Raynaud's Phenomenon (Raynaud's Disease)?
Raynaud's phenomenon takes its name from Maurice Raynaud, who first described this disorder in 1862.
Temporary restriction of blood flow to the skin by low temperatures or emotional stress situations is referred to as Raynaud's phenomenon or Raynaud's disease. Among the veins most affected in this ailment are the veins that feed the fingers and toes, the nose, and the skin of the lips. In some people, the vessels supplying the ear and nose may also be affected. The constriction of the vessels to restrict blood flow is called vasospasm.
What Causes Raynaud's Phenomenon (Raynaud's Disease)?
Raynaud's disease is seen approximately nine times more frequently in women than in men. People living in cold climates have also been found to have this disease more frequently. The fact that a quarter of Raynaud's patients have other family members with this disease indicates that this disorder may show a familial transmission.
The main triggers that may lead to the emergence of Raynaud's disease are exposure to cold and emotional stress situations. The blood flow of the fingers and toes is interrupted due to spasm in the veins in these people, where the body's reactions to temperature changes are different from normal. In some people, the contraction of the vessels causes the blood flow to be completely cut off, leading to changes that can be followed from the skin color.
Raynaud's attack can also be triggered after smoking, injuries in the hand and foot region, neuropathic diseases such as carpal tunnel, the use of certain drugs, and actions such as playing the piano or writing that require the same movement for a long time.
Raynaud's phenomenon ( The conditions that result in the occurrence of the disease) are divided into 2 categories, primary and secondary. It is examined in the following group:
Primary Raynaud's Disease
Primary Raynaud's disease occurs alone without any other underlying cause. Symptoms of this disease sometimes follow a mild to moderate course and may regress spontaneously. Secondary (Secondary) Raynaud's Disease
Raynaud's disease may occur due to many different reasons and these conditions are called secondary Raynaud's disease. Secondary Raynaud's disease most commonly occurs during the course of connective tissue diseases. Systemic lupus erythematosus, scleroderma and Sjögren's syndrome are among the connective tissue diseases in which secondary Raynaud's phenomenon occurs during its course. Secondary Raynaud's phenomenon can also be seen after the use of various drugs other than connective tissue diseases, and after excessive vibration exposure in people using heavy machinery. There is an increase in the incidence of Raynaud's phenomenon due to vascular problems that are common in people aged 60 and over.
What are the Symptoms of Raynaud's Phenomenon?
The most common symptom that occurs after the development of Raynaud's phenomenon is the discoloration of the fingers, nose and ears. The contractions in the vessels responsible for carrying blood to these areas and the areas where the blood flow is interrupted following this contraction become white, acquire a pale appearance and feel cold.
Because the tissues fed by the contracting vessels become oxygen-poor, the white color turns blue and this is called cyanosis. During the cyanosis period, the feeling of coldness becomes evident and numbness is added to the symptoms. At this stage, when the attack of the disease ends, twitching and tingling may occur in the fingers during the return of blood. Re-establishing the blood flow also ensures that the skin color, which turns from white to blue, regains its red color.
The duration of attacks that occur in this way in Raynaud's disease varies between a few minutes and a few hours. How is Raynaud's Disease Diagnosed?
In the diagnostic approach to Raynaud's disease, when the first attack occurs and it is important to examine what the triggering factors might be. The later the age of onset of the disease, the stronger the possibility that the underlying cause is a connective tissue disease.
At the same time, the presence of scar tissue in the affected areas is another important condition to be investigated as it can give an idea about the severity of the attacks.
Raynaud's disease typically affects the tips of the fingers. The phenomenon that starts in one finger begins to affect the other fingers, symmetrically and in both hands. The thumb is usually not affected by this condition. These typical findings of Raynaud's disease are symptoms that have diagnostic value during history taking and physical examination.
Another issue in the diagnostic approach of the disease is to distinguish between primary and secondary Raynaud's disease. Microscopic examination of the small vessels feeding the nail bed is performed. If enlargement and destruction of the vessels in the nail bed is detected as a result of this diagnostic method, called capileroscopy, the diagnosis of secondary Raynaud's disease is made.
If no abnormality can be detected other than when constriction of blood vessels occurs, the diagnosis is primary Raynaud's disease.
In addition to this method, laboratory examinations of the blood sample can also search for antibodies against diseases that may cause the development of Raynaud's syndrome. For example, a blood test that is positive for antinuclear antibody (ANA) may mean that Raynaud's phenomenon is caused by a connective tissue disease caused by autoimmune reasons.
How is Raynaud's Phenomenon (Raynaud's Disease) Treated?
The main purpose of the treatments applied in Raynaud's phenomenon is to reduce the frequency and severity of attacks. At the same time, it is aimed to prevent the affected area from being deprived of oxygen. Changes in lifestyle for the factors that trigger the contraction of the vessels are an important step in the treatment of Raynaud's disease. Limiting the consumption of foods containing caffeine and nicotine, which may have a stimulating effect on vasospasm, can be given as an example of lifestyle changes. It can make an impact. Avoiding emotional stress, another triggering factor, is another change you can make. In drug treatment, when deemed necessary by the physician, antidepressant drugs that have a vasodilating effect, some blood pressure drugs and drugs used in the treatment of erection problems in men can be applied.
People with primary Raynaud's disease tend to have a better prognosis than secondary Raynaud's because the disease regresses spontaneously and there are periods when the attacks are not seen for a long time. There is no spontaneous regression in secondary Raynaud's disease. Symptoms of Raynaud's disease may be relieved during pregnancy. The reason for this is considered to be the increase in the number of red blood cells and the amount of oxygen carried during pregnancy.
The person who realizes that he has had a Raynaud's attack can alleviate the symptoms that occur during the attack, such as heating the affected areas, moving to warmer indoor environments, immersing the affected areas in warm water or massaging those areas. The death of the tissue in the area due to lack of oxygen may reach dimensions that require amputation of this area. For this reason, people with signs and symptoms of this disease should apply to the nearest health institutions and get information about this disease from physicians.
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