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

Original text