If your hands turn purple when exposed to cold, don't be careless, it may be a rheumatic disease

Author: Zhao Xiaozhen Beijing Children's Hospital, Capital Medical University

Reviewer: Deng Jianghong, Chief Physician, Beijing Children's Hospital, Capital Medical University

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If the situation above occurs, be alert to Raynaud's syndrome!

What is Raynaud's syndrome?

Raynaud's syndrome is an arteriospastic disease, a syndrome in which spasms of small arteries at the extremities cause a series of skin color changes in the hands or feet. It can be divided into two categories: primary and secondary. The primary one is Raynaud's disease, which occurs without any underlying cause of any related systemic disease. The secondary one is also called Raynaud's phenomenon, which means there is an underlying disease that causes Raynaud's phenomenon. It is more common in clinical practice, accounting for about 2/3.

Secondary Raynaud's phenomenon is often accompanied by the following diseases: systemic scleroderma, systemic lupus erythematosus, dermatomyositis or polymyositis, rheumatoid arthritis, thromboangiitis, etc.

What are the causes and pathogenesis?

So, under what circumstances will Raynaud's phenomenon be induced? Many girls will find that their fingernails turn purple in the cold winter. This is because when the weather is cold, the outside world causes strong stimulation to the skin surface, which causes the temperature of the skin surface to drop, causing blood vessels to contract, resulting in poor blood circulation on the body surface. When blood accumulates, local skin hypoxia will cause the blood color to darken and the skin to turn purple. However, when entering a warm indoor environment, heating promotes blood circulation in the skin, weakens blood vessel contraction, and the skin returns to red. So is this a normal situation? If the degree is not serious, it is only a slight purple change, and it recovers quickly after being heated. In this case, you can add clothes when going out, keep warm, increase exercise, reduce outdoor activities in the cold, or eat some hot foods or rub the skin to promote blood circulation to relieve the symptoms. If the purple time is prolonged, or the skin on the fingertips turns white, you should pay attention to it at this time, and you can go to the rheumatology clinic to clarify the cause. When some patients are emotionally excited, their hands will turn purple or white. In this case, they also need to go to the rheumatology clinic. The typical Raynaud's phenomenon is that the fingers of both hands turn purple or white, not just the nails. If both fingers change, you definitely need to go to the hospital for treatment, but if only the nails of both hands change, do you need to go to the hospital for treatment? This situation needs to be determined based on the duration and degree of color change, as well as whether there is pain, etc. If the degree is very mild and the purple change lasts for a very short time, you can continue to observe. If it gets worse, you need to see a doctor in time.

What are the clinical manifestations?

In addition to the Raynaud's phenomenon of skin color changes mentioned above, what other symptoms may occur? You may experience rash, fever, photosensitivity, oral ulcers, hair loss, joint pain, etc. If any of the above symptoms occur, you also need to see a rheumatologist.

What tests are needed?

The examinations that need to be done include joint ultrasound, magnetic resonance imaging, blood routine, urine routine, liver and kidney function, autoantibodies, etc. If necessary, invasive examinations such as bone marrow puncture, kidney puncture, and skin puncture cannot be ruled out. Sometimes, in order to evaluate the involvement of organs, a full-body multi-organ examination is required.

What tests are needed?

General treatment: including washing hands with hot water, avoiding emotional excitement, avoiding strong light, avoiding cold stimulation, etc.

Drug treatment: improve microcirculation, apply immunosuppressants, etc. At the same time, you can also consult the Department of Traditional Chinese Medicine, which will also have good treatment methods!

Surgical treatment is usually not required.

What indicators need to be monitored during treatment?

1. The most important thing is to pay attention to changes in your own symptoms.

2. Monitor liver and kidney function and other adverse drug reactions.

3. At the same time, monitor whether any complications occur or whether any complications worsen.