Newspaper article The Canadian Press

Fingers, Toes That Go Dead White in Cold Could Be Sign of Raynaud's: Doctors

Newspaper article The Canadian Press

Fingers, Toes That Go Dead White in Cold Could Be Sign of Raynaud's: Doctors

Article excerpt

Fingers go white in cold? Could be Raynaud's

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When Michelle Richard was in her teens, she noticed the tip of one finger would periodically feel cold, turn dead white and then go a purplish-red colour.

"I would keep rubbing it until it got warm again and the blood started returning again to the finger," says Richard, 48, of Halifax, who thought the blanching of her finger might have been a long-term effect of frostbite from childhood.

But by the time she was in her mid-30s, the sudden loss of colour and feeling had encompassed all her fingers and toes, and she found out her condition had a name -- Raynaud's disease.

In her case, it was linked to the development of an autoimmune disease called scleroderma, which causes a hardening of skin and connective tissues, and in some people can affect blood vessels and internal organs.

Raynaud's also affects blood vessels, specifically the small arteries that supply blood to the skin in the extremities, causing them to constrict and cut off normal flow.

It's likely Richard's adolescent experience was due to so-called primary Raynaud's disease, a stand-alone condition unrelated to another disorder, which often begins between ages 15 and 30. Secondary Raynaud's, also called Raynaud's phenomenon, occurs in the presence of such autoimmune diseases as scleroderma, lupus and rheumatoid arthritis.

"If I'm having an attack, people will say, 'Oh my God, what's wrong with your hands?'" says Richard. "And certainly when they start to come back and you've got that bluish-red (colour), it almost looks like your hands are bruised."

Doctors aren't sure why some people are prone to the disorder, but it isn't caused by frostbite. There may be a genetic component and it's more common among those who live in cold climates. Smoking, which constricts blood vessels, is also considered a contributor.

Episodes of Raynaud's are typically triggered by exposure to cold temperatures, says Dr. Sasha Bernatsky, a rheumatologist at McGill University Health Centre in Montreal.

"The colour change means decreased blood flow to the digits, so that will sometimes mean unpleasant sensations, possibly pain or feeling very cold," she says. "The whole experience is due to these blood vessels that are oversensitive in a way and tend to constrict far more quickly and far more vigorously than we normally would see.

"Classically, it's cold, but anything that constricts the blood vessels, like stress, could perhaps bring on symptoms."

Certain jobs, such as those requiring repetitive use of jackhammers that expose the hands to intense vibration, can also lead to the development of the disease, as can vigorous or prolonged periods of playing the piano.

There are no official statistics on how many Canadians have Raynaud's, although the disorder is considered common. More women than men appear to have the disorder, in part because women are far more likely to develop autoimmune diseases, Bernatsky says. For instance, 90 per cent of lupus patients are female.

Attacks can affect just one or two fingers or toes, and the compromised digits aren't always the same from one episode to the next, says the Mayo Clinic on its website. Although Raynaud's most commonly strikes the fingers and toes, it can also cause other areas of the body -- such as the nose, lips, ears and even nipples -- to go numb and change colour, with attacks lasting less than a minute up to several hours. …

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