Raynaud’s Disease

Raynaud’s Disease: Understanding, Causes, and Treatment

Raynaud’s disease is characterized by sudden episodes of decreased arterial blood flow, primarily affecting the hands and feet, leading to tissue trophic disturbances.

Similar clinical signs may appear as a secondary condition, termed Raynaud’s syndrome, resulting from various diseases or external harmful effects such as vascular problems, collagen disorders, blood disorders, neurovascular diseases, toxicity, drug hypersensitivity, neurological disorders, and sometimes in cases of hyperthyroidism, primary pulmonary hypertension, followed by primary biliary cirrhosis, and musculoskeletal diseases.

Raynaud’s disease accounts for 70-85% of all cases of sudden blood circulation decrease in the extremities.

Contributing factors include genetics, decreased neural supply to blood vessels in peripheral vascular beds, psychological factors, central nervous system injuries, chronic nicotine and alcohol poisoning, hypothyroidism, infectious diseases, fatigue, and heat exposure. Meteorological effects and occupational hazards play a particular role, such as individuals living in cold and humid climates, chemical industry workers, miners, fishermen, and woodworkers.

There is an observed increase in incidence among individuals repeatedly exposed to hand stress: typists, drivers, pianists, among others.

Raynaud’s disease primarily affects young women (over 90%) aged 25-35 years, rarely occurring in children and the elderly. It exhibits a severe symmetrical effect, with hands affected before feet.

In the initial stage, short episodes occur in response to cold or psychological stress, leading to pallor, numbness, and loss of sensation in the fingers, accompanied by severe pain.

The second stage typically begins approximately 6 months later, characterized by longer episode durations and increased sensitivity to cold, followed by deep blue discoloration of the fingers after pallor, sometimes with moderate swelling. The pain is severe and burning.

The third stage, occurring in a few patients 1-3 years after disease onset, presents with all symptoms of the previous stage, with significant trophic disturbances:

  • Painful ulcers on the fingertips
  • Increased fragility of the fingers
  • Inability to tolerate low temperatures.

The fourth stage is marked by continuous pain and toxemia. Affected fingers are swollen and articulation is difficult, with skin color persistently blue, sometimes accompanied by dry gangrene of the nail layers.

Diagnostic methods include cold testing, radiography, thermography, capillaroscopy, rheovasography, and plethysmography for associated diseases with vascular disorders.

Treatment involves:

  • Removing risk factors
  • Sedative therapy
  • Overcoming vascular constriction
  • Pain management
  • Improving microcirculation
  • Correcting rheological disorders
  • Combating autoimmune sensitivity and immune deficiency
  • Improving tissue nutrition and strengthening blood vessel walls.

It is noteworthy that pregnancy and childbirth often lead to spontaneous healing of Raynaud’s disease.

In cases where conservative treatment is ineffective, surgical procedures such as sympathectomy, open intervention, visual methods, and amputation of fingertips are indicated, which are advanced measures performed in less than 1% of patients.