Reynaud disease

Reynaud disease (synonym gangrene symmetric) is a disease of the group eritropoetinov, manifested paroxysmal spasm of the arteries of the hands and feet. The etiology is unknown.
In the development of the disease Reynaud is set to a pathological condition vasomotor centers of different departments of vegetative nervous system.
The first stage of the disease characterized by episodic sharp poslednee fingers, and sometimes the legs, often symmetrically on two legs. Skin is cold to the touch. Patients often experience tingling, crawling, and sometimes pain. Attack lasts, as a rule, 5-10-20 minutes, after which the color of the skin gradually becomes normal. Cooling of the extremities contributes to attack.
Raynaud's disease

Fig. 4-6. Raynaud's Disease. Fig. 4. The first stage - ischemia fingers. Fig. 5. The second stage is cyanosis fingers. Fig. 6. Third stage - gangrene of fingers.

In the second stage of the skin during the attack bluish coloration. The attack is accompanied by more intense pains and disorders of sensitivity. Cooling of the extremities enhances the blueness and pain.
In the third stage there are trophic disturbances in the fingers of the affected limbs in the form of bubbles, followed by the formation of trophic ulcers or necrosis of soft tissues and bones with gangrene and the gradual rejection of individual sections of the fingers. The disease is progressing.
The treatment of a disease Reynaud: apply vasodilator drugs (papaverine inside of 0,02-0,04 g 2-3 times a day or intramuscularly in a dose of 2 ml of 2% solution), daily and ganglioblokirute funds (pahikarpin inside of 0.1 g 2-3 times a day for 10-15 days; gangleronum inside of 0.04 g 3 times a day or intramuscularly in a dose of 1 ml of 1.5% solution 2-3 times a day). Useful application of thermal procedures: a warm hand and foot bath (temperature 37-38 degrees according 10-15 minutes) and mud treatment (temperature of mud 37-38 degrees) in the affected limbs and spine - cervical and Wernigerode Department for hands, nizhnegorodski and lumbar foot. Very important to take preventive measures, preventing the development of trophic disorders (ulcers, gangrene). Avoid cooling and mechanical injury.

Reynaud disease (morbus Raynaud; synonym: gangrene symmetric, asphyxia localis symmetrica, Reynaud syndrome) is a disease caused by pathological state of vasomotor centers located in different departments of vegetative nervous system. The etiology and pathogenesis of the disease is not clear. When illness Reynaud mainly affects the apparatus of the autonomic nervous system, and it can be centers of the hypothalamus, and the sympathetic ganglia edge of the trunk, and vasomotor arteriocapillary network. 3. C. Melnicka believes that when illness Reynaud, is close arteriovenous anastomoses, leads to local asphyxia, so characteristic of the disease Reynaud. Attempts have been made to classify the disease Reynaud to the group kollagenozov. The disease occurs primarily in young age and more often in women.
For the clinical picture of the disease characterized by a cold snap, and then blanching of the fingers, mainly due to cooling. There parestesia, pain, pain. Such an attack can last from several minutes to several hours. The second stage of the process is accompanied by the blue fingers (asphyxia localis) due atony capillaries and stagnation in their blood. This stage occurs pristupoobrazna, and the attacks are more prolonged than spasms in the first stage. The third stage is usually develops after a prolonged attack of the second stage, bubbles with bloody contents, which later formed necrotic ulcer different depths, sometimes down to the bone. In the following may occur mummification of one or more fingers. Their backslidings are scarring. In some cases there is a simultaneous spasm of blood vessels the bottom of the eye, what confirms the view that Raynaud's disease is a systemic disease that is affecting different parts of the vascular system. In some cases the disease join the phenomena of sclerosis (see), which significantly worsens the prognosis.
To differentiate Raynaud's disease should primarily with obliterating endarteritis (see). It is established that obliterative endarteritis affected first the lower limbs, Raynaud's disease usually begins with a defeat of hands.
The treatment of a disease Reynaud extremely difficult due to lack of clarity of the pathogenesis of the disease and the difficulties impact on the course main process in the autonomic nervous system. It is recommended to use ganglioblokirute funds, since in some cases the disease Reynaud, there are reasons to think about the localization process nodes edge of sympathetic trunk. Nominated: pahikarpin 0.1 g 2 times a day for 10-15 days, gangleronum 0.04 g tablets 3-4 times a day, or by injection of 1.5% solution of 1 ml intramuscularly 2-3 times a day for 10-15 days, and other
From the Spa procedures are recommended: 1) hydrosulphuric baths with temperature 35-36 degrees and concentration to 100 mg/l for 10-15 minutes, only 12-14 baths treatment; 2) mud applications with temperature 36-37 degrees according to 10 - 15 minutes segmental neck (collar zone) and locally on a brush with the General rate of 12-14 procedures. If there sklerodermia phenomena mud applications are not shown.
Of physical therapy are applied: 1) inductothermy on the area of the cervical sympathetic nodes weak intensity and duration of procedure is from 8 to 15 minutes, the course of treatment is 12 procedures; this method is shown in the first and second stages of the disease; 2) ultraviolet irradiation collar zone intensity 2-3 biodozy on the front surface of the neck and 3-4 biodozy on the rear surface. The dose of irradiation can be gradually increased to achieve erythema reaction. With the failure of conservative treatment, with the appearance of trophic disorders, the development of scleroderma A. L. Polenov and A. C. Bondarchuk recommend surgical treatment as preganglionarnah sympathetic rajkotia CVI - ThI.