Acrocyanosis

Definition
Acrocyanosis is a decrease in the amount of oxygen delivered to the extremities. The hands and feet turn blue because of the lack of oxygen. Decreased blood supply to the affected areas is caused by constriction or spasm of small blood vessels.

Description
Acrocyanosis is a painless disorder caused by constriction or narrowing of small blood vessels in the skin of affected patients. The spasm of the blood vessels decreases the amount of blood that passes through them, resulting in less blood being delivered to the hands and feet. The hands may be the main area affected. The affected areas turn blue and become cold and sweaty. Localized swelling may also occur. Emotion and cold temperatures can worsen the symptoms, while warmth can decrease symptoms. The disease is seen mainly in women and the effect of the disorder is mainly cosmetic. People with the disease tend to be uncomfortable, with sweaty, cold, bluish colored hands and feet.

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Causes and symptoms
The sympathetic nerves cause constriction or spasms in the peripheral blood vessels that supply blood to the extremities. The spasms are a contraction of the muscles in the walls of the blood vessels. The contraction decreases the internal diameter of the blood vessels, thereby decreasing the amount of blood flow through the affected area. The spasms occur on a persistent basis, resulting in long term reduction of blood supply to the hands and feet. Sufficient blood still passes through the blood vessels so that the tissue in the affected areas does not starve for oxygen or die. Mainly, blood vessels near the surface of the skin are affected.

Diagnosis
Diagnosis is made by observation of the main clinical symptoms, including persistently blue and sweaty hands and/or feet and a lack of pain. Cooling the hands increases the blueness, while warming the hands decreases the blue color. The acrocyanosis patient’s pulse is normal, which rules out obstructive diseases. Raynaud’s disease differs from acrocyanosis in that it causes white and red skin coloration phases, not just bluish discoloration.

Treatment

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There is no standard medical or surgical treatment for acrocyanosis, and treatment, other than reassurance and avoidance of cold, is usually unnecessary. The patient is reassured that no serious illness is present. A sympathectomy would alleviate the cyanosis by disrupting the fibers of the sympathetic nervous system to the area.owever, such an extreme procedure would rarely be appropriate. The same effect could be accomplished with a-adrenergic blocking agents or caclium channel blockers

Acrocyanosis usually isn’t treated. Drugs that block the uptake of calcium (calcium channel blockers) and alpha-one antagonists reduce the symptoms in most cases. Drugs that dilate blood vessels are only effective some of the time. Sweating from the affected areas can be profuse and require treatment. Surgery to cut the sympathetic nerves is performed rarely.

Incidence, Prevalence, and Epidemiology
Although there is no definitive reporting on its incidence, acrocyanosis shows prevalence in children and young adults than in patients thirty years of age or older. Epidemiological data suggests that cold climate, outdoor occupation, and low body mass index are significant risk factors for developing acrocyanosis. As expected, acrocyanosis would be more prevalent in women than in men due to differences in BMI. However, the incidence rate of acrocyanosis often decreases with increasing age, regardless of regional climate. Case reports have found acrocyanosis to be more prevalent in patients with autistic disorders such as Asperger’s Syndrome.

Prognosis
Acrocyanosis is a benign and persistent disease. The main concern of patients is cosmetic. Left untreated, the disease does not worsen.

Newborn Considerations
Acrocyanosis is common initially after delivery in the preterm and full term newborn Intervention normally is not required, although hospitals opt to provide supplemental oxygen for precautionary measures.

 

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.healthline.com/galecontent/acrocyanosis
http://en.wikipedia.org/wiki/Acrocyanosis_%28benign%29

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