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White and Blue Fingers and Toes? What’s the Cause?

For some people, extreme cold or emotional or physical stress can quickly turn their normally flesh-colored fingers and toes white and/or blue – sometimes leading to very painful digits.

The discoloration and pain is often caused by a condition called Raynaud’s disease or Raynaud’s phenomenon. For many, it is mild and can be addressed with simple lifestyle changes, such as wearing gloves and warm socks or slippers during the winter months. For others, though, the discoloration and pain can be long-lasting, sometimes even resulting in sores and the ultimate loss of portions of fingers and toes.

“Patients with severe or secondary Raynaud’s can experience severe pain and develop  sores or ulcers on the tips of the fingers and toes that don’t heal,” says Dr. Paul Dellaripa. “These patients should be seen by a clinician who is skilled with managing patients with severe Raynaud’s, as they are at the highest risk of losing digits due to infection or gangrene.”

For some people, extreme cold or emotional or physical stress can quickly turn their normally flesh-colored fingers and toes white and/or blue – sometimes leading to very painful digits.

Raynaud’s phenomenon is characterized by vasospasm – a sudden constriction of blood vessels that severely reduces blood flow to the fingers and toes. The condition is most often provoked by exposure to cold, but also can be triggered by emotional or physical stress. Smoking also is a risk factor for the condition. Raynaud’s phenomenon can exist as an isolated condition (known as primary Raynaud’s disease), which is seen more frequently in women and people who live in colder climates. It also occurs in men and women who have autoimmune or connective tissue diseases, as well as other diseases. This is known as secondary Raynaud’s.

Dr. Dellaripa is part of a multidisciplinary team in the Raynaud’s Disease Clinic, which includes experts in vascular medicine, rheumatology, pulmonology, and plastic surgery. The team provides innovative and comprehensive care to patients with Raynaud’s disease, who often have other conditions that make them more susceptible to Raynaud’s and who are likely to benefit from a collaborative approach to care.

“We work together to try various approaches, including different medications which can be given orally or applied locally to the affected areas,” says Dr. Aaron Waxman. “We also participate in clinical trials with novel agents to improve symptoms, especially for patients who haven’t responded to previous therapy.”

Specialists in the Raynaud's Disease Clinic are currently enrolling patients with primary or secondary Raynaud’s phenomenon in a pilot study of oral treprostinil, which is used in the treatment of pulmonary arterial hypertension. For more information on this study, please contact Sergio A. Segrera at (617) 732-4954 or ssegrera@partners.org.

-Jessica F.