© 1996 British Society for Rheumatology
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NON-INVASIVE ASSESSMENT OF VASCULAR REACTIVITY IN FOREARM SKIN OF PATIENTS WITH PRIMARY RAYNAUD'S PHENOMENON AND SYSTEMIC SCLEROSIS
University of Manchester Rheumatic Diseases Centre, Hope Hospital Salford M6 8HD
*Medical Statistics Unit, Lancaster University Lancaster LAI 4YF
Correspondence to:
Correspondence to: A. L. Herrick, University of Manchester Rheumatic Diseases Centre, Hope Hospital, Salford M6 8HD
We have non-invasively assessed neurovascular control mechanisms in forearm skin of 10 healthy control subjects, eight patients with primary Raynaud's phenomenon (PRP) and 10 patients with systemic sclerosis (SSc) by iontophoresing acetylcholine (endothelial dependent), sodium nitroprusside (endothelial independent) and adrenaline, and measuring subsequent blood flow responses by dual-channel laser Doppler. Because basal forearm blood flow is low, adrenaline response was assessed by attenuation of reperfusion hyperaemia following 60 s of upper arm occlusion. Reperfusion hyperaemia prior to adrenaline iontophoresis differed significantly between groups (F2.21, = 4.3, P = 0.03), being lowest in the SSc and highest in the PRP group. However, the degree of attenuation of this hyperaemia by adrenaline did not differ between groups and all groups demonstrated similar vasodilatory responses to acetylcholine and to sodium nitroprusside. These findings may reflect that abnormalities in vascular tone in patients with Raynaud's phenomenon are local to the digits, or that vasoactive agents not examined in this study play a key role.
KEY WORDS: Iontophoresis, Laser Doppler, Primary Raynaud's phenomenon, Systemic sclerosis, Scleroderma, Neuroendothelial control
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