Raynaud’s and Perniosis

 Raynauds and Perniosis

 

Raynaud’s Phenomenon

·         Is a vasospastic disease that affects the blood supply to the fingers and toes (rare but can affect the tip of the nose/earlobes.

·         Triggered by exposure to the cold, stress/psychological upsets

·         Pt will report one or more fingers turning white/numb, blue during rewarming and then bright red due to increased blood flow.  Pt can report that it lasts minutes to hours.

·         Can be primary (not associated with any disease process) or secondary (due to another disease process)

o   Causes of Secondary Raynauds

§  Systemic Sclerosis (crest syndrome)

§  Systemic Lupus Erythematous

§  Dermatomyositis

§  Sjogren syndrome

§  Granulomatosis with polyangiitis

§  Drugs- B blocker, clonidine, bleomycin, bromocriptine, imipramine, OCPs

§  Atherosclerosis

§  CVA

§  Multiple Sclerosis

§  Polio

§  Occupational causes- using vibrating tools- pneumatic drill operators, lumberjacks

 

Chilblains (also known as Pernio or Perniosis)

·         It is a localized form of vasculitis.  Red/purple patches that can be painful, pruritic, and may blister, scab or ulcerate.  Affected areas may be swollen.

·         Occurs several hours after cold exposure and lasts between 7-14 days

·         Common locations: fingers/toes, heels, lower extremities, nose, ears (wrists in babies)

o   Peds: may recur each winter and then suddenly resolve

o   Elderly: tends to recur yearly and likely to worsen each year

·         Pt’s with poor peripheral circulation are more likely to develop chilblains

Adapted from:

DermNet NZ. (2016). Retrieved from http://www.dermnetnz.org