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Pathophysiology of Raynaud's Disease

Jonathan L. Halperin, MD; Jay D. Coffman, MD
Arch Intern Med. 1979;139(1):89-92. doi:10.1001/archinte.1979.03630380067022.
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Vasospasm implies reversible vasoconstriction that may diminish blood flow to supplied tissues. Initially described by Maurice Raynaud in 1862, episodic vasospastic ischemia of the digits characterizes Raynaud's phenomenon; the idiopathic variety is termed Raynaud's disease. The typical acute attack comprises sequential phases of digital pallor, cyanosis, and rubor induced by cold or emotive stimuli. The well-demarcated pallor of a part or all of one or more digits during an episode of vasospasm is presumed to derive from spastic constriction of the digital arteries or arterioles, while subsequent cyanosis is attributed to retarded blood flow in dilated capillaries and venules. After a period of minutes to several hours, local rubor develops as a consequence of reactive hyperemia. In some patients only pallor or cyanosis occurs. Dysesthesiae and regional diaphoresis may coincide with the ischemic phase, while throbbing pain often accompanies recovery. Trophic changes of sclerodactyly and, rarely, fingertip ulcerations or gangrene,

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