Raynauds by drdoc on-line
Raynauds can be seen as a primary
or secondary to an underlying disease.
1 pallor - the
digits go white.
The damage occurs during the phase where the tissues are not
perfused with blood -the pallor phase.
The therapy is difficult.
1. It is vital that you keep the peripheries warm and this means GLOVES and even warm socks especially in the morning. It is very difficult to avoid cold exposure of the peripheries in a USA winter, let alone one of our mild South African winters, but you have to make a plan.
2. Medications that I have found useful include
b. Topical TNT Glyceryl trinitrate therapy - applied as a paste in tiny quantity to the fingers. The ointment is actually used by angina sufferers. Too much applied can cause a headache as some is absorbed.
c. Loftyl a vasodilator made by abbot laboratories - one twice a day as required. Again too much may cause slight dizziness by an effect on blood pressure.
d Iloprost, for treatment of Raynauds Phenomenon is still being studied but looks promising
f. Surgical cervical sympathectomy-is an option you often see surgeons performing usually by the time an internist or rheumatologist has seen the case (not surprising as they tend to be more aggressive souls). My experience does not show a good success rate for them and recurrence is frequent post op.
Bottom line-----best advice - keep the peripheries as warm as possible--especially in the morning
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