Four patients with marked sensitivity to cold were selected to illustrate aspects of the clinical spectrum of this common disorder. Tissue turgor of the fingertip as measured with the tonometer was increased in all four patients. Digital rheoplethysmographic findings in one patient showed normal vasoconstrictive response to cold. However, in another patient who had marked swelling of the hands with exposure to cold, the rheoplethysmographic recordings of the digital circulation after exposure to cold were similar to those observed after injections of bradykinin and during reactive hyperemia, suggesting constriction of the arteriovenous shunts and digital veins with simultaneous dilatation of the digital arteries.
Therapy for such patients should emphasize maintenance of warmth of body and extremities. Satisfactory pharmacologic treatment is currently not available.