Hands are "frozen white"! This may be an immune disease

"Frozen!" is a common exclamation in the coldest days of winter, but have you ever experienced "frozen white"? Recently, the reporter noticed on multiple platforms that more than one netizen posted their experience of their fingers being frozen to a completely white color. However, Gu Bingjie, attending physician of the Rheumatology and Immunology Department of Nanjing First Hospital, pointed out that this situation is likely a sign of Raynaud's syndrome and needs to be checked in a regular hospital in time.

Young girl's fingers turned white due to cold

After the winter solstice, the coldest days of winter begin. Since ancient times, there is a saying among the people that "don't touch your hands during the first and second nine days of winter". I believe many people have experienced their hands being "frozen" in the winter. However, recently, reporters found on several platforms that some netizens posted photos of their fingers being frozen to the point of being completely pale and bloodless.

In the video posted by the user, she said that she had just finished driving and her hands were "frozen white". It can be clearly seen that her index finger, middle finger, ring finger, and little finger are pale from the fingertips to the second and third joints, forming a sharp contrast with the color of her palms.

Coincidentally, a blogger on a certain platform also posted that in winter, her hands and feet would become cold, numb and stiff, and her fingers would turn pale. She would feel better after going back to the house and getting some fresh air. The photos posted by the blogger attracted a lot of attention from netizens. The reporter noticed that many comments reminded her that this was probably a manifestation of Raynaud's syndrome, a rheumatic immune disease, and reminded the blogger to seek medical attention as soon as possible.

Secondary Raynaud's syndrome

Mostly related to rheumatic immune diseases

What is Raynaud's syndrome? Are "frozen white" fingers really that dangerous? "Raynaud's syndrome is a translation of Raynaud's syndrome. French scholar Raynaud first reported this phenomenon in 1862." Gu Bingjie, attending physician of the Department of Rheumatology and Immunology of Nanjing First Hospital, introduced that "Raynaud's" is not just the fingers being frozen white, but a process. "After being cold or emotionally excited, the patient's skin color often suddenly turns pale from the fingertips, and then turns purple. Gradually spread to the entire finger and palm, accompanied by local cooling, numbness, and decreased sensation." At this time, the "Raynaud's" process is not over yet. After a few minutes, the skin will flush, warm up, and feel a burning pain, and the skin color will slowly return to normal.

The reporter learned that there are two types of Raynaud's syndrome: primary and secondary. Cold stimulation, emotional excitement, nervous excitement, occupational factors such as workers who work with vibrating machinery for a long time, endocrine disorders, genetics, fatigue, infection, etc. may all be the causes of primary Raynaud's syndrome. "In addition, some are related to smoking. Previously, we encountered a 50-year-old man in the clinic who came to see a doctor for Raynaud's phenomenon. He had severe pain at the end of his fingers and could not fall asleep at night. After a series of examinations ruled out secondary rheumatic diseases, we considered that it was related to his heavy smoking," said Gu Bingjie.

Secondary Raynaud's syndrome is different. Gu Bingjie said that secondary factors mainly include diseases, trauma and drugs. "The most common cause of Raynaud's syndrome is connective tissue disease, which is the rheumatic immune disease known to the public. It includes systemic sclerosis (scleroderma), systemic lupus erythematosus, dermatomyositis or polymyositis, rheumatoid arthritis, Sjögren's syndrome, etc."

Don't panic!

Specialized instruments can give a clear diagnosis

However, not all fingers that turn white should be cause for panic. Gu Bingjie pointed out that if a person has Raynaud's phenomenon and is also accompanied by unexplained fever, arthritis, rash, oral ulcers, dry mouth and eyes, hard skin, muscle aches, dysphagia, dry cough, chest tightness and shortness of breath, or a physical examination reveals a decrease in the three blood series, abnormal liver function, infertility in young people, pathological pregnancy, etc., then it is recommended that such people go to the rheumatology and immunology clinic in time for screening for rheumatic and immunological diseases. "In addition to doing some routine blood tests, including routine blood and urine tests, coagulation tests, and biochemistry, we have some rheumatology and immunology specialty examination items such as: 3 rheumatism items, immunoglobulins, complement, and various antinuclear antibodies," Gu Bingjie reminded.

The reporter learned that in the Rheumatology and Immunology Department of Nanjing First Hospital, there is a magical machine - nail fold microcirculation instrument, which is specially used to determine secondary Raynaud's phenomenon. Abnormal nail fold microcirculation itself is one of the diagnostic criteria for systemic sclerosis. Gu Bingjie introduced that during the examination, a layer of pine tar oil needs to be applied around the nail of the patient's ring finger of the non-dominant hand (usually the left hand) and then placed under a microscope to observe the arrangement, morphology and blood flow velocity of microvessels in the nail bed.

"The shape of normal capillaries is that old-fashioned black hairpin, almost symmetrical on both sides, with a bend on the top, forming an inverted U shape, uniform in shape and neatly arranged. There are about 10 blood vessels in a row under one field of view, and the blood flow is very fast. If you don't look carefully, you can't see it flowing. It rushes past quickly and changes into a "linear flow." However, when Raynaud's syndrome occurs, the tissue around the nail fold proliferates, and the capillaries dilate compensatorily and become thicker, but the number decreases. The blood flow inside is very slow, showing granular flow or slow granular flow, and the cells inside are queuing up one by one, as if "you squeeze me and I push you." In severe cases, a large number of red blood cells can be seen gathering and even white microthrombi can be formed.

"Some patients with severe scleroderma have a significantly reduced number of nail fold capillaries, which are short and small, with only a small amount of blood flowing through them, so patients will develop fingertip ulcers or even necrosis."

However, Gu Bingjie also said that if it is Raynaud's phenomenon secondary to connective tissue disease, there is no need to worry. Most people can get varying degrees of relief after treatment with hormones and immunosuppressants, and can feel the "warmth" in their hands and feet.

Source: Yangtze Evening News, Beijing Evening News