raynaud

Raynaud phenomenon is a condition that affects your blood vessels (the tubes that your blood flows through). It causes your blood vessels to narrow, which decreases blood flow. This is called a Raynaud episode or "attack." The attacks usually affect your fingers and toes, causing them to become cold and numb. They may also change color, usually to white or blue. These attacks happen in response to cold temperatures or stress.

Raynaud phenomenon may also be called Raynaud disease or Raynaud syndrome.

There are two types of Raynaud phenomenon:

• Primary Raynaud phenomenon is the more common type. Its cause is unknown.
• Secondary Raynaud phenomenon is usually caused by another disease or problem, such as lupus or scleroderma. Other causes may be exposure to cold or certain chemicals. The type can be more serious than the primary type.

Researchers don't know exactly why some people develop Raynaud phenomenon. But they do understand how the attacks happen. When you are exposed to cold, your body tries to slow the loss of heat and maintain its temperature. To do this, the blood vessels in the top layer of your skin constrict (narrow). This moves blood from those vessels near the surface to vessels deeper in the body. But when you have Raynaud phenomenon, the blood vessels in your hands and feet react to cold or stress by narrowing quickly. They also stay narrowed for a long time.

Anyone can develop Raynaud phenomenon, but some people are more likely to develop it:

• Primary Raynaud phenomenon has been linked to:
  • Your sex. Women get it more often than men.
  • Your age. It usually develops in people younger than age 30. It often starts in the teenage years.
  • A family history of Raynaud phenomenon. You are more likely to develop Raynaud phenomenon if you have a family member who has it.
• Secondary Raynaud phenomenon has been linked to:
  • Certain diseases. These include lupus, scleroderma, rheumatoid arthritis (RA), carpal tunnel syndrome, and connective tissue disorders.
  • Certain medicines. Medicines that treat high blood pressure, migraines, and attention deficit hyperactivity disorder (ADHD) may cause similar symptoms to Raynaud phenomenon or make your symptoms worse.
  • Work-related exposures, such as repeated use of vibrating machinery (such as a jackhammer), or exposure to cold or certain chemicals.

Raynaud attacks most often happen when you get cold, for example when you grab something cold from the freezer or go into an air-conditioned building on a warm day. Attacks usually affect your fingers and toes. But sometimes they can affect other parts of your body, such as your ears, nose, lips, or nipples.

An attack causes the skin to become cold and numb. Your skin may also turn white or blue due to a lack of oxygen. As the blood flow returns, your skin may tingle, throb, or turn red. An attack may last a few minutes or a few hours. If you have darker skin, you may not be able to easily see the skin color changes.

For many people, especially those with the primary type, the symptoms are mild. People with the secondary type often have more severe symptoms. They may develop skin ulcers (open sores caused by poor blood flow) or skin infections.

There is no specific test to diagnose Raynaud phenomenon. To find out if you have it, your health care provider:

• Will take your medical history and ask about your symptoms.
• Will do a physical exam.
• May order blood and other lab tests to check for other conditions which could be causing your symptoms and/or to help decide which type of Raynaud phenomenon you have.

Most people with Raynaud phenomenon can keep their symptoms under control by avoiding getting cold. But if this is not enough, medicines and, in some cases, surgical procedures can help.

Secondary Raynaud phenomenon is more likely to be serious and to need more treatments. It's also important to treat the condition or problem that is causing your Raynaud phenomenon.

You may need to see a specialist such as a rheumatologist, a doctor who treats diseases of the joints, muscles, and bones.

Raynaud phenomenon cannot be prevented, but you can help prevent attacks and manage your symptoms by:

• Placing your hands or feet in a warm place when you have an attack. This could mean putting them under warm (not hot) water or under a heating pad.
• Keeping your body, especially your hands and feet, warm in cold weather.
• Avoiding triggers, such as certain medicines and stress.
• Quitting smoking (or not starting smoking).
• Managing stress.

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases

Lupus is a chronic (long-lasting) type of autoimmune disease.Autoimmune diseases happen when your immune system attacks healthy cells and tissues by mistake. This attack causes inflammation. It can also damage many parts of the body, including the joints, skin, kidneys, heart, lungs, and brain.

There are several types of lupus:

• Systemic lupus erythematosus (SLE) is the most common type. It can be mild or severe and can affect many parts of the body.
• Cutaneous lupus affects the skin. It causes a rash or sores, usually after your skin is exposed to sunlight. The two major types of cutaneous lupus are discoid lupus and subacute cutaneous lupus.
• Drug-induced lupus is caused by a reaction to some medicines. The symptoms may start 3 to 6 months after starting the medicine. The symptoms usually go away when you stop taking the medicine.
• Neonatal lupus, which is rare, affects newborns. It is caused by certain antibodies that are passed from the pregnant parent to the baby.

The cause of lupus is unknown. Researchers are studying what might cause or trigger the disease, such as:

• Genetics
• Environmental factors, such as viral infections, sunlight, certain medicines, and smoking
• Problems with the immune system

Anyone can get lupus, but women get it much more often than men.

Lupus is more common in African Americans than in White people. It is also more common in people of American Indian and Asian descent. African American and Hispanic women are more likely to have severe forms of lupus.

Lupus can have many symptoms, and they differ from person to person. Some of the more common ones are:

• Arthritis, causing painful and swollen joints and morning stiffness
• Fever
• Fatigue or feeling tired often
• Red rashes, most often on the face (also called the "butterfly rash")
• Chest pain when taking a deep breath
• Hair loss
• Pale or purple fingers or toes, from cold and stress (Raynaud phenomenon)
• Sensitivity to the sun
• Swelling in legs or around eyes
• Mouth ulcers
• Swollen glands
• Headache and dizziness
• Confusion and memory problems

Symptoms may come and go. When you are having symptoms, it is called a flare. Flares can range from mild to severe. New symptoms may appear at any time.

Lupus causes inflammation throughout your body. This can cause problems in your organs, including:

• Kidney damage (lupus nephritis).
• Heart problems, including inflammation in the heart (myocarditis), heart valves, or lining of the heart muscle (pericarditis).
• Inflammation of blood vessels (vasculitis).
• Blood clots
• Inflammation of the tissue that surrounds the lungs (pleurisy). This can make it painful to breathe.

Some people with lupus may be more likely to develop other conditions, such as coronary artery disease (CAD) and atherosclerosis.

There is no specific test for lupus, and it's often mistaken for other diseases that cause similar symptoms. So it may take a while to get a diagnosis. To find out if you have lupus, your health care provider:

• Will ask about your symptoms, medical history, and family health history
• Will do a complete physical exam
• May order blood tests, such as ANA (antinuclear antibody), antibodies, complete blood count, and complement tests
• May order other tests, such as urine tests
• May do biopsies:
  • Skin biopsy (looking at skin samples under a microscope)
  • Kidney biopsy (looking at tissue from your kidney under a microscope)

There is no cure for lupus, but medicines and lifestyle changes can help control it.

People with lupus often need to see different providers. You will most likely have a primary care provider and a rheumatologist (a doctor who specializes in diseases of the joints and muscles). Which other specialists you will depend on how lupus affects your body. For example, if lupus is damaging your heart or blood vessels, you would see a cardiologist (a doctor who specializes in heart diseases).

Your primary care provider should coordinate care between all of your other providers and treat other problems as they come up. You and your primary care provider will develop a treatment plan to fit your needs. You will both review the plan often to make sure that it is working. You should report new symptoms to your provider right away so that your treatment plan can be changed, if needed.

The goals of a treatment plan are to:

• Prevent flares
• Treat flares when they occur
• Reduce organ damage and other problems
• Improve your quality of life

Treatments may include drugs to:

• Reduce fever, swelling, and pain
• Reduce inflammation in your body
• Prevent or reduce flares
• Reduce or prevent damage to joints
• Suppress (lower) the activity of your immune system

Besides taking medicines for lupus, you may need to take medicines for problems that are related to lupus such as high cholesterol, high blood pressure, or infection.

Alternative and complementary therapies are therapies that are not part of standard treatments. Some people try alternative and complementary therapies to improve their lupus symptoms. But research has not clearly shown whether these treatments may help or treat lupus. Talk to your provider before trying any new treatments.

It is important to take an active role in your treatment. It helps to learn more about lupus - being able to spot the warning signs of a flare can help you prevent the flare or make the symptoms less severe.

It is also important to find ways to cope with the stress of having lupus. Exercising and finding ways to relax may make it easier for you to cope. A good support system can also help.

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases

Scleroderma means "hard skin." It's the name of an autoimmune disease that causes inflammation and thickening in the skin and other areas of the body. This inflammation causes you to have areas of tight, hard skin. Scleroderma may affect just one area of your body, or it can affect many systems in your body.

There are two main types of scleroderma:

• Localized scleroderma only affects your skin and the muscles and tissues just under your skin.
• Systemic scleroderma, which is also called systemic sclerosis, is a more serious type. It affects many parts of your body and can damage your blood vessels and internal organs, such as your heart, lungs, and kidneys.

The exact cause of scleroderma is unknown. Researchers think that several factors may play a part in causing the disease:

• Your genetics. Certain genes can increase the chance that you will develop scleroderma. They may also play a role in which the type of scleroderma you have. Scleroderma is not passed from parent to child, but you are more likely to develop it if a close relative has it.
• Your environment. Exposure to certain things in the environment, such as viruses or chemicals, may trigger scleroderma.
• Immune system changes. When your immune system changes, it can trigger your cells to make too much collagen in the body. Too much collagen causes patches of tight, hard skin.
• Hormones. Hormonal or immune system differences between women and men might play a part in the disease.

Anyone can get scleroderma, but certain factors may make you more likely to develop it:

• Your sex. Scleroderma is more common in women than in men.
• Your age. The disease usually appears between the ages of 30 and 50.
• Your race. Scleroderma can affect people of all races and ethnic groups, but the disease can affect African Americans more severely.

The symptoms of scleroderma are different for each person, depending on the type of scleroderma you have:

• Localized scleroderma usually causes patches of thick, hard skin in one of two patterns:
  • Patches in firm, oval shapes that stay in one area or spread to other areas of skin. This is called morphea.
  • Lines of thickened or different colored skin that run down your arm, leg, and, rarely, on the forehead. This is called linear scleroderma.
• Systemic scleroderma can cause problems with your internal organs as well as your skin. It can cause symptoms such as:
  • Thick, tight skin on your fingers
  • Fatigue
  • Raynaud's phenomenon, a narrowing of blood vessels in the hands or feet
  • Damage to your internal organs, including your digestive system, lungs, kidneys, and heart

There is no single test for scleroderma. The symptoms can vary from person to person and can be similar to those of other diseases. This can make scleroderma hard to diagnose.

To find out if you have scleroderma, your health care provider:

• Will ask about your symptoms and medical history
• Will do a physical exam
• May order blood tests, including an ANA (antinuclear antibody) test
• May do a skin biopsy
• May do other tests, such as imaging tests, to check for organ damage

There is no cure for scleroderma, but treatments can help control your symptoms and limit damage. The treatments may include:

• Medicines to help decrease swelling, manage pain, control other symptoms, and prevent complications.
• Physical or occupational therapy to help with pain, improve muscle strength, and teach you ways to help with daily living.
• Regular dental care, because scleroderma can make your mouth dry and damage connective tissues in your mouth. These problems can speed up tooth decay and cause your teeth to become loose.

You may need to see specialists to help treat your disease. Many people with scleroderma will see a rheumatologist. This is a doctor who specializes in rheumatic diseases such as arthritis and other inflammatory or autoimmune disorders. Dermatologists, who specialize in conditions of the skin, hair, and nails, may also play an important role in treating the disease. And if you have organ damage, you may need to see other specialists.

You can also help manage some of your symptoms, for example by:

• Dressing warm and avoiding cold or wet environments
• Quitting smoking (if you smoke)
• Putting on sunscreen before you go outdoors
• Using moisturizers on your skin to help lessen stiffness
• Avoiding hot baths and showers, harsh soaps, and household cleaners
• Getting regular physical activity

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases

Your vascular system is your body's network of blood vessels. It includes your:

• Arteries, which carry oxygen-rich blood from your heart to your tissues and organs
• Veins, which carry the blood and waste products back to your heart
• Capillaries, which are tiny blood vessels that connect your small arteries to your small veins. The walls of the capillaries are thin and leaky, to allow for an exchange of materials between your tissues and blood.

Vascular diseases are conditions which affect your vascular system. They are common and can be serious. Some types include:

• Aneurysm - a bulge or "ballooning" in the wall of an artery
• Atherosclerosis - a disease in which plaque builds up inside your arteries. Plaque is made up of fat, cholesterol, calcium, and other substances found in the blood.
• Blood clots, including deep vein thrombosis and pulmonary embolism
• Coronary artery disease and carotid artery disease, diseases that involve the narrowing or blockage of an artery. The cause is usually a buildup of plaque.
• Raynaud phenomenon - a disorder that causes the blood vessels to narrow when you are cold or feeling stressed
• Stroke - a serious condition that happens when blood flow to your brain stops.
• Varicose veins - swollen, twisted veins that you can see just under the skin
• Vasculitis - inflammation of the blood vessels

The causes of vascular diseases depend on the specific disease. These causes include:

• Genetics
• Heart diseases such as high cholesterol and high blood pressure
• Infection
• Injury
• Medicines, including hormones

Sometimes the cause is unknown.

The risk factors for vascular diseases can vary, depending on the specific disease. But some of the more common risk factors include:

• Age - your risk of some diseases goes up as you get older
• Conditions that can affect the heart and blood vessels, such as diabetes or high cholesterol
• Family history of vascular or heart diseases
• Infection or injury that damages your veins
• Lack of exercise
• Obesity
• Pregnancy
• Sitting or standing still for long periods of time
• Smoking

The symptoms for each disease are different.

To make a diagnosis, your health care provider will do a physical exam and ask about your symptoms and medical history. You may have imaging tests and/or blood tests.

Which treatment you get depends on which vascular disease you have and how severe it is. Types of treatments for vascular diseases include:

• Lifestyle changes, such as eating a heart-healthy diet and getting more exercise
• Medicines, such as blood pressure medicines, blood thinners, cholesterol medicines, and clot-dissolving drugs. In some cases, providers use a catheter to send medicine directly to a blood vessel.
• Non-surgical procedures, such as angioplasty, stenting, and vein ablation
• Surgery

There are steps you can take to help prevent vascular diseases:

• Make healthy lifestyle changes, such as eating a heart-healthy diet and getting more exercise
• Don't smoke. If you are already a smoker, talk to your health care provider for help in finding the best way for you to quit.
• Keep your blood pressure and cholesterol in check
• If you have diabetes, control your blood sugar
• Try not to sit or stand for up long periods of time. If you do need to sit all day, get up and move around every hour or so. If you are traveling on a long trip, you can also wear compression stockings and regularly stretch your legs.

You use your fingers and thumbs to do everything from grasping objects to playing musical instruments to typing. When there is something wrong with them, it can make life difficult. Common problems include:

• Injuries that result in fractures (broken bones), ruptured ligaments and dislocations
• Osteoarthritis - wear-and-tear arthritis. It can also cause deformity.
• Tendinitis - irritation of the tendons
• Dupuytren's contracture - a hereditary thickening of the tough tissue that lies just below the skin of your palm. It causes the fingers to stiffen and bend.
• Trigger finger - an irritation of the sheath that surrounds the flexor tendons. It can cause the tendon to catch and release like a trigger.

No matter how old you are or what you do for a living, you are always using your hands. When there is something wrong with them, you may not be able to do your regular activities.

Hand problems include :

• Carpal tunnel syndrome - compression of a nerve as it goes through the wrist, often making your fingers feel numb
• Injuries that result in fractures (broken bones), ruptured ligaments and dislocations
• Osteoarthritis - wear-and-tear arthritis, which can also cause deformity
• Tendinitis - irritation of the tendons
• Disorders and injuries of your fingers and thumb