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International Angiology 2001 December;20(4):307-13

Copyright © 2002 EDIZIONI MINERVA MEDICA

lingua: Inglese

Raynaud’s phenomenon (primary or secondary to systemic sclerosis). The usefulness of laser-Doppler flowmetry in the diagnosis

Del Bianco E., Magini B., Muscarella G., Cappugi P., Lotti T.

From the Department of Dermatological Science, University of Florence, Florence, Italy


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Background. Raynaud’s phe­nom­e­non (RP) con­sists of pain­ful vas­cu­lar ­spasms of ­the extrem­ities ­stressed by ­cold expo­sure. It is ­often a symp­tom, in ­many cas­es ­the ­onset, of system­ic scler­o­sis (SSc). The ­aim of ­this ­study ­was to eval­u­ate ­the ­role ­that laser-Doppler flowmetry (­LDF) ­could ­have in ­the dif­fe­ren­tial diag­no­sis of ­these dis­or­ders ­and to char­ac­ter­ize ­the func­tion­al beha­vi­our of the micro­ves­sels in RP.
Methods. In ­this ­study we exam­ined 52 ­patients (five ­males ­and 47 ­females, ­aged 17-57) affect­ed by pri­mary RP, 21 ­patients (three ­males ­and 18 ­females, ­aged 31-63) affect­ed by RP sec­on­dary to SSc as ­defined by Wouda in 1987 ­and 20 ­healthy sub­jects (three ­males ­and 17 ­females, ­aged 26-58) by ­means of ­­LDF ­with an appro­pri­ate ­cold-­test (11°C ­for 2 min).
Results. We ­show ­that ­the ­cold ­test ­applied at ­hand lev­el ­can dis­tin­guish RP ­patients ­from ­healthy sub­jects. Data ­show ­that ­basal ­blood ­flow of ­patients affect­ed by SSc is dimin­ished in ­its medi­um val­ue ­and ­presents a typ­i­cal trac­ing with­out vas­o­mo­tion in com­par­i­son to ­healthy sub­jects ­and ­also to ­patients affect­ed by pri­mary RP. On ­the ­basis of ­our ­data ­among ­the pri­mary RP ­patients we ­can ­also dis­tin­guish a ­group ­that ­show ­basal ­blood ­flow trac­ing ­very sim­i­lar to ­that of scler­o­der­mic ­patients. These sub­jects ­should be care­ful­ly fol­lowed-up.
Conclusions. In con­clu­sion, it ­could be stim­u­lat­ing ­for ­the ­future to intro­duce ­LDF as a com­ple­men­tary meth­od ­for ­the diag­no­sis of RP ­and pos­sibly ­for ear­ly dis­crim­i­na­tion ­between ­the pri­mary dis­eas­e ­and ­that sec­on­dary to SSc.

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