｜Planning/Editing: Ya Yun Editor in Charge: Yellow&Fanny
Review: Li Yun
I don’t know if you were once lovers of “Youth Pain Literature”.
One thing to say, Benhua was a senior Mary Sue literary expert when she was a student (who doesn’t have an unforgettable past).
According to the countless experiences of reading, it is found that in ancient novels, in order to create the fragility of the little white flower heroine, there are often words similar to “The fingertips are frozen to white” description.
I didn’t expect that when I was browsing a red book some time ago, I saw a scene where this novel came into reality.
Image source network
This user posted a message lamenting that his fingers started to turn white in large areas when they were stimulated by the cold. As a result, she was seen by a medical student netizen on the spot, pointing out that it was Raynaud’s phenomenon, and asked her to seek medical examination immediately.
Oh? I used to check Baidu when I was sick, but now I rely on netizens to see a doctor.
After reading the comments of netizens, the original Po owner was also scared to go to the hospital for a diagnosis and examination, and is currently facing active treatment.
Image source network
So what is the origin of this often overlooked disease? Don’t be careless when you encounter it, it may be a sign of some systemic diseases!
What is Raynaud’s phenomenon
Raynaud’s phenomenon is a acral arteriole spasm caused by cold or excitation of the sympathetic nervous system.
The pallor, cyanosis, and redness of the fingers or toes can be induced and exacerbated by cold stimuli or emotional stress.
It is more common in young and middle-aged women, and has a familial tendency. Mild cases may be accompanied by pinning, numbness or pain in the extremities, and in severe cases ulcers may appear on the tips of the fingers and toes.
Causes
The pathogenesis of Raynaud’s phenomenon is a extremely complex process closely related to nerve, blood vessel, blood flow factors, The levels of autoantibodies, genes and hormones all have certain effects on the pathogenesis.
Raynaud’s phenomenon can be divided into primary and secondary according to the presence or absence of primary disease, with 80% of The case was secondary.
The pathology and pathogenesis of primary Raynaud’s phenomenon are not well understood.
The secondary is mainly caused by other diseases such as autoimmune diseases, nerve and vascular compression syndromes, infections, endocrine diseases, blood diseases, malignant tumors, etc. cause.
The clinical severity of Raynaud’s phenomenon varies from person to person and can range from a simple discomfort to a condition that significantly affects a patient’s quality of life.
Symptoms
Raynaud’s syndrome usually begins in a single finger and spreads symmetrically to the other fingers of the hands, the index, middle, and ring fingers are the most common.
When the fingers (or toes) are stimulated by cold or emotional changes, the skin of the extremities will appear pale cyanotic flushing in turn. “Triphasic” color changes, and in some cases pale cyanosis, or cyanotic flushing “biphasic” color changes.
Image source network
3 stages of a typical seizure
Ischemia (pale)
Paroxysmal spasm of arterioles in the fingers or toes, ischemia of the local tissue, causing pale, cool limbs.
It usually starts at the tips of the fingers (toes) and gradually spreads to the bases of the fingers (toes), and may be accompanied by cold sweating on the skin, ants walking or pain. The duration varies, sometimes up to 15-20 minutes.
Hypoxia (cyanosis)
Due to reduced local blood supply, tissue ischemia and hypoxia, telangiectasia and congestion, skin cyanosis and purple, usually lasting several minutes.
Congestive Period (flushing)
Relief of arteriolar spasm, arterial congestion, skin temperature rise, skin flushing, and a gradual return to normal skin tone within minutes.
If Raynaud’s phenomenon recurs, resulting in dystrophic nails and skin, reduced lines on the fingers, hard skin, thinning of the pulp, fingertip ulcers, and small areas of gangrene are likely to occur /strong>, often accompanied by severe pain, and punctate skin scars may be left after the ulcer heals.
Primary Raynaud’s phenomenon often has no or minimal changes in the vessel wall, while patients with secondary (especially from connective tissue disease) are often due to the underlying disease Lead to changes in the structure of the blood vessel wall, resulting in persistent and repeated vasospasm.
How to Improve and Treat
Raynaud’s phenomenon is still an incurable disease with no effective cure.
Current clinical treatment is mainly to improve vasoconstriction, reduce the occurrence of Raynaud’s phenomenon and its complications, thereby improving the quality of life of patients and preventing repeated ischemic tissue damage.
Remove the cause
Patients with secondary Raynaud’s phenomenon are recommended to go to the Rheumatology and Immunology Department, Hematology Department, Endocrinology Department for related primary disease treatment.
In addition, it is important to removerisk factors for arteriosclerosis.
Daily Protection
Includes Avoid cold exposure, keep your body warm, quit smoking, avoid stress, stress, and use sympathomimetic drugs.
Medications
Long-acting dihydropyridine calcium channel blockers, such as nifedipine or amlodipine, can be used in patients with recurrent attacks and severe symptoms.
If calcium channel blockers cannot be used or patients with poor tolerance can choose alternative treatment options: phosphodiesterase type 5 inhibitors, topical nitrates, or topical Injection of botulinum toxin type A.
Surgical Treatment
Surgical treatment (such as sympathectomy) can be considered to relieve symptoms of the disease when medical treatment is ineffective, but it cannot be cured, and 15% of patients’ symptoms will continue after surgery , the recurrence rate is high.
Finally, let me remind again that Raynaud’s phenomenon is often an early symptom of some systemic diseases. If you find yourself with similar symptoms, don’t take it lightly. Early screening for the cause is very important. Be sure to go to the regular hospital rheumatology and immunization department as soon as possible.
Click watching+share to let more people know Raynaud phenomenon.
Have you seen any outrageous descriptions in novels? Looking forward to meeting you in the message area~
[References]
[1] Liu Lulu, Nie Zhiyu. Progress in the treatment of Raynaud’s phenomenon with botulinum toxin[J]. Stroke and Neurological Diseases, 2021,28(04):478-481.
[2] Zhang Yutian, Wang Hong, Feng Binbin, Wang Yuehao. Advances in the diagnosis and treatment of Raynaud’s syndrome [J]. Journal of Vascular and Endovascular Surgery, 2020, 6(05): 450 -456.DOI:10.19418/j.cnki.issn2096-0646.2020.05.017.
[3] He Jiaojiao, Niu Hongqing, Li Xiaofeng, Cao Jianping. Research progress on the pathogenesis of Raynaud’s phenomenon [J]. Chinese Journal of Clinicians (Electronic Edition), 2016, 10(23): 3618-3621.
[4] Liu Jing, Shi Qun, Xu Dong, Hao Donglin, Zhao Yan. The spectrum and clinical characteristics of autoimmune diseases with Raynaud’s phenomenon as the first manifestation[J]. Journal of Allergy, 2013, 7(04):346-350.