| Planner/Editor: Ya Yun Editor:Yellow & Fanny
Review: Li Yun
I don't know if you were once a fan of "youth pain literature".
One thing to say is that Ben Hua was also a senior Mary Sue literary taster when he was a student (who did not have a past that could not be looked back).
According to the countless experiences of reading texts, it is found that in ancient novels, in order to create the fragility of the heroine of the little white flower, there are similar descriptions of "fingertips frozen to white".
I didn't expect that some time ago, when I was browsing a red book, I saw a scene of this novel shining into reality.
Graph source network
The user posted lamenting that his fingers began to turn white in a large area when stimulated by the cold. As a result, the medical student netizens saw the doctor on the spot, pointed out that this was the Renault phenomenon, and asked her to quickly seek medical examination.
Oh yeah? In the past, I was sick to check Baidu, and now I rely on netizens to see a doctor.
After reading the netizens' messages, the original po owner was also frightened to go to the hospital for diagnostic examination and is currently actively treating the face.
So what is the origin of this often overlooked disease? Don't be careless when you encounter it, it may be a sign of some systemic disease!
What is Raynaud's phenomenon
Raynaud's phenomenon refers to spasm of the fine arterioles of the extremities due to cold or sympathetic nervous system excitement.
Pallor, cyanosis, and redness may occur on the fingers or toes, and cold irritation or emotional stress can induce and aggravate.
Young adult women are more common and have a family genetic predisposition. Mild patients may have pinpricks, numbness, or pain in the extremities, and in severe cases ulcers on the tips of the fingers and toes.
Cause of onset
The pathogenesis of Raynaud's phenomenon is an extremely complex process, closely related to nerve, blood vessel, and blood flow factors, and autoantibodies, genes, and hormone levels all have a certain impact on the onset of the disease.
Raynaud's phenomenon can be divided into primary and secondary diseases or not, and 80% of cases are secondary.
The pathology and pathogenesis of primary Raynaud's phenomenon are not well understood.
Secondary diseases are mainly caused by other diseases such as autoimmune diseases, neurological and vascular compression syndromes, infections, endocrine diseases, blood diseases, malignant tumors, etc.
The clinical severity of Raynaud's phenomenon varies from person to person and can range from simple discomfort to conditions that seriously affect the quality of life of patients.
Symptoms manifest
Episodes of Raynaud's phenomenon usually begin with a single finger and then spread symmetrically to the rest of the fingers of the hand, with the index, middle, and ring fingers being the most common.
When the fingers (or toes) are stimulated by cold or mood changes, the "three-phase" color change of pale cyanosis flushing will occur in the skin of the extremities, and in some cases, there will be pale cyanosis, or the "biphasic" color change of cyanosis flushing.
3 stages of a typical seizure
Ischemic phase (pallor)
Paroxysmal arteriole spasm of the fingers or toes, local tissue ischemia, causing the limbs to be pale and cool.
It usually begins with the tip of the finger (toe) and gradually spreads to the root of the finger (toe), and may be accompanied by cold sweat, ant walking, or pain in the skin. Duration varies, sometimes up to 15 to 20 minutes.
Hypoxia phase (cyanosis)
Due to decreased local blood supply, tissue ischemia and hypoxia, telangiectasia and congestion, cyanosis and purple skin, which usually lasts for several minutes.
Congestion phase (flushing)
Arteriolar spasm relieves, arterial congestion, skin temperature rises, skin flushing, gradually returns to normal skin tone within a few minutes.
If Raynaud's phenomenon recurs, resulting in trophic deficits in the nails and skin, it is easy to have reduced finger lines, hardened skin, thinning of the fingertips, ulcers at the ends of the fingers and small areas of gangrene, often accompanied by severe pain, and punctate skin scars can be left after the ulcers heal.
Primary Raynaud's phenomenon often has no or minimal vascular wall changes, while patients with secondary (especially secondary to connective tissue disease) often have structural changes in the vascular wall due to underlying disease, resulting in persistent and recurrent vasospasm.
How to improve and treat
Raynaud's phenomenon is still an incurable disease and there is a lack of effective cures.
At present, clinical treatment is mainly to improve vasoconstriction, reduce the occurrence of Raynaud's phenomenon and its complications, thereby improving the quality of life of patients and preventing repeated ischemic tissue injury.
Remove the cause
Patients with secondary Raynaud's phenomenon are recommended to go to the Department of Rheumatology and Immunology, The Department of Haematology, and the Endocrinology Specialty for related primary disease treatment.
In addition, it is important to remove the high-risk factors for arteriosclerosis.
Daily protection
These include avoiding cold exposure, keeping the whole body warm, quitting smoking, avoiding stress, stress, and the use of sympathomimetic drugs.
Medication measures
For patients with recurrent episodes and severe symptoms, long-acting dihydropyridine calcium-like channel blockers such as nifedipine or amlodipine may be used.
Alternative treatment options may be available for patients who are not available or who are poorly tolerated: phosphodiesterase type 5 inhibitors, topical nitrates, or topical botulinum toxin type A.
Surgical treatment measures
Surgical treatment (e.g., sympathetic ganglion) may be considered to alleviate symptoms when pharmacotherapy is ineffective, but radical cure is not achieved, and symptoms continue in 15% of patients after surgery, with a high recurrence rate.
Finally, once again, Raynaud's phenomenon is often an early symptom of some systemic diseases, if you find yourself with similar symptoms, you must not take it lightly, early screening of the cause is very important, be sure to go to the rheumatology and immunology department of a regular hospital as soon as possible.
Hands-on pointing in the watch + share, so that more people know the Renault phenomenon.
What other outrageous depictions in novels have you seen? Looking forward to meeting you in the message area~
〔Reference〕
Liu Lulu,Nie Zhiyu. Progress in the treatment of Raynaud's phenomenon with botulinum toxin[J].Stroke and Neurological Diseases,2021,28(04):478-481.
Zhang Yutian,Wang Hong,Feng Binbin,Wang Yuehao. Advances in the diagnosis and treatment of Raynaud's syndrome[J].Journal of Vascular and Endovascular Surgery,2020,6(05):450-456.DOI:10.19418/j.cnki.issn2096-0646.2020.05.017.
He Jiaojiao,Niu Hongqing,Li Xiaofeng,Cao Jianping. Research progress on the pathogenesis of Raynaud's phenomenon[J].Chinese Journal of Clinicians (Electronic Edition),2016,10(23):3618-3621.
Liu Jing,Shi Qun,Xu Dong,Hao Donglin,Zhao Yan. Disease spectrum and clinical characteristics of autoimmune diseases with Raynaud's phenomenon as the first manifestation[J].Chinese Journal of Clinical Immunology and Allergy,2013,7(04):346-350.