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© 1990 British Society for Rheumatology

other

EVIDENCE FOR AN ABNORMAL PERIPHERALLY MEDIATED VASCULAR RESPONSE TO TEMPERATURE IN RAYNAUD'S PHENOMENON

D. WALMSLEY and M. J. D. GOODFIELD

University Departments of Medicine and Dermatology, The General Infirmary Leeds LSI 3EX

Correspondence to: Correspondence to Dr D. Walmsley

It is unclear whether an abnormal vascular response to temperature change, independent of central sympathetic control, exists in Raynaud's phenomenon. We investigated this using the hyperaemic response to localized heating of dorsal foot skin, recorded by laser Doppler flowmetry. Fifteen normal adults, nine patients with primary, and seven with secondary Raynaud's phenomenon were studied. On warming, blood flow normally increases gradually at first, followed by rapid vasolidation at temperatures above 33°C. Normal geometric mean (95% confidence interval) blood flows at 33°C and 36°C were 0.19 (0.16–0.22) and 0.39 (0.29–0.53) arbitrary units respectively. In primary Raynaud's phenomenon, blood flows were 0.53 (0.44–0.62) and 1.07 (0.86–1.35) arbitrary units respectively(P≤0.01 compared to normal subjects), showing early vasodilatation. Normal women have an intermediate response between men and primary Raynaud's patients. Responses in secondary Raynaud's phenomenon widely overlap the other groups. We conclude that an abnormal peripheral vascular response to temperature change exists in primary Raynaud's phenomenon

KEY WORDS: Blood flow, Vasodilatation, Warming, Skin temperature


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