STUDIES OF THE MECHANISM OF CIRCULATORY INSUFFICIENCY IN RAYNAUD'S DISEASE IN ASSOCIATION WITH SCLERODACTYLIA

Abstract

Sclerodactylia and scleroderma are often associated with Raynaud's disease. Most frequently the changes in the skin occur after the vasospastic syndrome has been present for some time. Sclerodactylia occasionally occurs without pathologic arterial spasm and in some cases may precede the attacks of local asphyxia of the fingers. Occasionally the changes in the skin and the vasospastic attacks in the fingers begin simultaneously. Raynaud1 observed the association of these closely related conditions and accurately described sclerodactylia in some of his case reports (cases 8, 11 and 15).^1a The skin and subcutaneous tissues in sclerodactylia are fibrotic, hard and inelastic. In severe forms the fibrosis may be so marked that motion of the fingers becomes impossible. The nails become deformed; the articulations are destroyed, and the bones, especially the terminal phalanges, are atrophied. The skin is stretched and pale, and the creases present in all normal skin are obliterated. The fingers