Is a vasospastic disorder characterized by one or more fingers becoming blanched, cyanotic and red (often in that order), on exposure to cold stimuli or emotional stress. There could be attendant discomfort and pain the fingers. May ultimately lead to ulceration, tissue necrosis and gangrene. More common in women and in the young <40 years. Causes include collagen disorders, drugs like beta-blockers, ergotamine, estrogens, use of vibratory tools, carpal tunnel syndrome etc. called raynaud’s disease, when idiopathic.
Treatment
Non-pharmacologic method very effective. Treat background illness, if causative. Avoid causes like stress, caffeine, nicotine and nasal decongestants. Wear gloves when indicated. Calcium channel blockers like Nifedipine, felidipine, isradepine are quite useful. Limited effect seen with Ace inhibitors, prazosin, minoxidil, nitroglycerine which also have unacceptable side effects. IV prostacyclin analogue lloprost useful in resistant cases
