QUERY:
I have been told I have Raynauds. I started with typical symptoms of
that, numb, cold, white fingertips after exposure to cold. This has
gotten worse. I now have intense itching and swelling if an area of my
body is exposed to a temperature drop. At the beach I stood by the
waters edge and my legs became bright red, began to itch and swelled
until they were uncomfortable. My ears, fingers, hands are very
sensitive to temperature changes but even if a part of my body is
covered it can be affected. I attended a football game and sitting on
the bleachers caused my butt to itch madly. If I dig in the dirt in the
spring my fingers itch. I guess you get the point.
My question is whether or not Raynauds progresses to this state or if I
now have something else and should see my doctor again.
I take Zoloft daily but that is the only medication I take regularly.
Thank you
ANSWER:
It does sound like you had the typical symptoms of Raynaud's originally but
now have moved on to a problem called "cold urticaria and angioedema". In
real English, that means "itching and hives caused by exposure to cold,
accompanied by swelling of the tissues".
The good news is that there are ways to manage this so you can sit on the
bleachers and dig in your garden! Some of the management is the same as for
Raynauds - staying warm and not exposing yourself to cold. Some of the
management is using medications, and your doctor can help you with that.
There are several types that help and the side effects of these medications
are usually not a problem.
However, a caveat: make sure the diagnosis is right before you start taking
medicine to treat the symptoms. There are a few things that should be ruled
out before you settle on cold urticaria or simple Raynauds, and your doctor
can do the tests to check for those. The lab should test you for your liver
functions, for rheumatic diseases like 'scleroderma', and a general
screening to include thyroid function and your complete blood count.
To educate yourself a bit more about this whole problem, I've included a few
links here that have a wealth of information.
First, for more information regarding Raynauds syndrome:
Raynaud's disease (primary Raynaud's phenomenon). The cause is unknown, and
the symptoms are usually stable.
Secondary Raynaud's phenomenon. Predisposing factors include
atherosclerosis, arteritis, cancer, collagen vascular disease, thoracic
outlet syndrome, embolic occlusions, occupational disease (working outdoors,
using vibrating tools), and certain drugs (beta-adrenergic blockers,
nicotine, ergotamine).
http://www.arthritis.co.za/raynauds.html
Now, cold urticaria:
Cold urticaria causes weals and swelling on skin exposed to a reduction in
temperature. Wealing can be widespread and may result in fainting. It is
more severe in winter, and usually affects face and hands. Affected
individuals should take care not to expose large areas of the skin to the
cold or to the wind. They should not swim by themselves.
http://www.dermnet.org.nz/dna.urticaria/urt.html
After checking these links, you will be ready to return to your doctor with
some helpful ideas to help manage your problem. Good luck!
In good health,
Dr. Kerr