Clinical Photography, Central Manchester University Hospitals NHS Foundation Trust, UK / Science Source
SAN DIEGO—Top researchers gathered for a review course at the start of the 2017 ACR/ARHP Annual Meeting in November to describe new research, their own treatment strategies and new ways of thinking about an array of rheumatic diseases. Here are the highlights:
Raynaud’s & Other Digit Problems
When a patient walks into your clinic with blue fingers or toes, it can be a dramatic situation that requires quick action. Fred Wigley, MD, director of the Johns Hopkins Scleroderma Center in Baltimore, discussed these types of cases at the review course. He offered lessons on how this problem comes about, how to discern the cause and what to do about it.
Under normal conditions, the vessels regulating temperature subtly shift blood flow throughout the body to maintain the right temperature in the body’s core. The skin has an incredible capacity for this blood flow, able to accommodate 60% of the cardiac output. These thermal regulatory vessels are controlled by alpha 2 receptors that pick up norepinephrine from the sympathetic nervous system that can be triggered by skin cooling or a central body chill. Then the shunt contracts and restricts flow to the blood surface.