LUPUS: A Guide for Nurses
The blood supply to the extremities, usually the fingers and toes but sometimes also the ears and nose, is interrupted. The stimulus is usually a change in temperature or stress. The extremities become white and dead-looking, may turn blue and then bright red, perhaps with considerable pain, numbness or tingling.
Primary Raynauds: the condition occurs spontaneously and the patient may be any age. It can be hereditary, may be fairly mild and women are mainly affected.
Secondary Raynauds: less common yet more serious and early, accurate diagnosis is vital - it links with underlying diseases such as Scleroderma, lupus, Sjögren's and rheumatoid arthritis.
Treatment is difficult. Drug therapy sometimes helps those with intense pain or digital ulcers, but the response is variable. In many patients with Raynauds wearing warm gloves is most practical.
A disease of the immune system, blood vessels and connective tissue. Skin, usually of the hands and feet, becomes stiff, white and shiny due to swelling and then thickening of connective tissue which becomes fibrotic and scarred - the internal organs can be affected similarly. Scleroderma patients in general may experience dryness of the eyes and mouth, bloating or abdominal pain, difficulty in swallowing, tiredness and lack of energy, weakness, weight loss and aching muscles and joints.
Localised Scleroderma (morphea), occurs in isolated areas of the skin; it does not affect internal organs and is relatively mild. The condition often develops in childhood and can affect the growth of a limb.
Treatment There is no one "magic" drug. Exercise is very important in helping keep the skin flexible, the blood flowing freely and the affected joints moving. With skin care, the aim is to ensure a good supply of blood to the skin and this helps retain body and extremities' warmth, and use of skin soaps, creams and oils can assist.