Raynaud's Disease, which may be either primary or secondary, is characterised by extreme coldness in the hands or feet, following which the fingers or toes become white and numb. The colour may then change to blue when the blood is cut off, and finally red when the blood returns to the tissues. This can take several minutes or many hours, and can be extremely painful. It may also affect the ears and nose.
Raynaud's Disease affects over 10% of the population (more than 350,000 people in Ireland) and is much more common in women, especially young females. In many cases it is so mild that it is little more than a nuisance, in others the symptoms are severe enough to cause considerable discomfort on a regular basis. Ulceration can also occur and care needs to be taken to prevent infection. Cuts to the hands and feet should be carefully looked after and reported to the doctor if they do not clear up reasonably quickly.
A careful clinical history, physical examination and tests, such as capillary microscopy, enable the doctor to diagnose whether the patient has primary Raynaud's (not associated with any other condition) or if it is secondary to another underlying disease, such as scleroderma, systemic lupus erythematosus or rheumatoid arthritis. Blood tests will help to identify an underlying connective tissue disorder and x-rays, along with doppler ultrasound studies, may reveal arterial abnormalities. If auto-antibodies are present in the blood, the patient should be referred to a consultant. It is essential that people with significant Raynaud's are screened for a possible underlying condition.
Treatment may vary according to the severity of the symptoms. In mild Raynaud's it may be sufficient to maintain a constant body temperature, and, if possible, avoid extreme cold and sudden changes in temperature. Attacks can also be caused by stress and smoking. It is important to prevent Raynaud's attacks as far as possible. There are a number of options for treating more severe Raynaud's, such as calcium channel blockers, vasodilators, or infusions of Iloprost. Your doctor will decide on the most suitable treatment. Supplementary Vitamins C and E may be prescribed. Some patients find benefit by taking ginger, garlic or gingko biloba. What suits one person may not suit another, and all treatment should be undertaken in consultation with your medical advisers.
Associated Conditions - Scleroderma
- Mixed Connective Tissue Disease
- Rheumatoid Arthritis
- Lupus — Systemic Lupus Erythematosus
- Erythromelalgia
- Sjogren's Syndrome
- Vibration White Finger
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