It could be Raynaud’s phenomenon, a benign disorder but which sometimes signals rheumatic diseases such as lupus, rheumatoid arthritis and connective tissue diseases.
When the temperatures drop, it is normal for the hands to be the first to suffer but, if in addition to becoming cold, they undergo color changes, it is possible that you are facing Raynaud’s phenomenon. Described for the first time in 1862 by the French doctor of the same name. This problem can sometimes be the wake-up call for rheumatological diseases, so it’s best not to underestimate it.
What does Raynaud’s phenomenon consist of?
characterized by the appearance of circulatory manifestations especially in the extremities, in particular in the hands and sometimes in the feet. The fingers of the hands pass from an initial paleness to a phase of cyanosis (i.e. blue-purplish in color) e finally to a persistent phase of redness which corresponds to a resumption of circulation – he explains Luigi Sinigaglia, past-president of the Italian Society of Rheumatology -. These disorders are typically triggered byexposure to low temperatureshowever, emotional or physical stress can also be involved. From the point of view of the classification there are two types of Raynaud’s phenomenon: the primitive one and the secondary one.
The first expression of a local defect in thermoregulation, of a constitutional type. Generally a non-worrying phenomenon that occurs already at a young age, especially in women.
The secondary Raynaud’s phenomenon, on the other hand, can be an indicator of rheumatological diseases such as scleroderma, connective tissue diseases in general, systemic lupus erythematosus and rheumatoid arthritis itself
. it is relatively frequent in young people, especially women, and can occur several years before other manifestations of rheumatological disease appear.
Other causes of secondary forms can be ascribed to some medications, for example beta blockers o ad some professionssuch as those for example where necessary work with vibrating tools. To be called into question may also be extra-rheumatological pathologies that can involve an ischemic obstacle to circulation in the upper limbs (thoracic outlet syndrome).
How can the secondary Raynaud’s phenomenon be framed?
If the hand manifestations associated with cold are suspected to be an expression of a rheumatological disease blood tests need to be done, in particular the search for anti-nuclear and anti-ena antibodies. Their positivity is very suggestive of a possible connectivity. Confirmation can be obtained by executing capillaroscopy. With this non-invasive examination, the vascularization of the skin at the base of the nail is analyzed. In the primary forms the capillaries appear normal, while in the secondary forms typical anomalies can be found.
How can this be countered?
The primitive Raynaud is usually a benign phenomenon that you can dominate with simple tricks such as being careful not to expose yourself to the cold, cover up well or use a hand warmer. When hand manifestations are secondary to a systemic connective tissue disease the first step frame and treat the underlying pathology. If the phenomenon is particularly serious, to the point of exposing itself to the risk of real cold skin ulcers, we can count on some drugs capable of inducing peripheral vasodilation (prostanoids or prostacyclin analogs). In these cases, infusion therapies are used, usually only in the winter months, because when the temperature rises, the symptoms decrease or disappear.
Does the cold make the disease worse?
The low temperature they have no particular effects on rheumatological diseases, apart from the vascular aspects typical of Raynaud’s phenomenon. It is possible that the cold slightly increases the perception of pain, muscle contracture or joint pain, but in fact there is no correlation with a possible worsening of the disease, explains Sinigaglia.
How to understand when they are chilblains?
Another unfortunate side effect of exposure to the cold is represented by
chilblains which are the result of an abnormal reaction of the body to the cold followed by a sudden heating. Chilblains develop several hours after exposure to the cold with burning and itching in the affected areas, typically fingers or toes. If the individual enters a warm environment, the ailments worsen: Fingers take on a red to blue color, are often painful and can even blister or ulcers. If further exposure to cold is avoided, chilblains usually heal within a few weeks and cause no permanent damage. instead it is good to consult a doctor if the chilblains are severe or recurrent and if they do not improve in a short time.
March 4, 2022 (change March 4, 2022 | 12:59)
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