Acrocyanosis - this change in the color of the skin on the distal parts of the body, which are bluish.The pathogenesis of acrocyanosis is a violation of blood flow through the microvasculature at the level of arterial capillary networks in the skin.
cyanotic color of the skin in the distal parts of the extremities and the face is a reflection of violations of cardiac hemodynamics in general, so the appearance of this symptom in a person suffering from chronic cardiac pathology, is considered to be a poor prognostic criteria.
Acrocyanosis refers to one of the main criteria for the development of chronic cardiovascular disease, but it should be remembered, and other possible etiological factors, provoking a sharp change in color of the skin of varying degrees of intensity.
maximum acrocyanosis manifestations have been reported in patients after cardiac surgical interventions for valvular heart disease with the establishment of the arterio-venous shunt.
Depending on the nature of the occurrence, there are several specific types of acrocyanosis: Essential (mostly occurs in girls during puberty active) and anesthetic (it contributes to the emergence of a direct effect of cold stimulus to the skin).
If we consider the pathogenetic chain of acrocyanosis, the main element of it is the increase in concentration of the reduced hemoglobin fraction as part of venous blood, which occurs when a significant reduction in the rate of movement of blood through the vessels and subject to the increased oxygen consumption by various tissues and structures.
typical classic version of acrocyanosis is a central type, the cause of which is considered a total loss hypoxic peripheral tissues of the human body, resulting lowering of blood oxygen saturation of the pulmonary circulation.
Acrocyanosis indicate a violation of the right heart cardiac hemodynamics in contrast to the diffuse form of cyanosis, which is a reflection of the increase in the concentration of reduced hemoglobin in the whole flow of the circulating blood.
separate etiopathogenetic form acrocyanosis is spasmodic, which is observed among adolescent age period, suffering from asthenic-vegetative syndrome, accompanied by spasms of small caliber vessels in response to any stimuli (cold, stress, physical activity).In this situation, more damaged subcutaneous and intradermal small arterial vessels of a capillary network.
intensity bluish color of the skin depends on the density structure of the skin and its individual transparency.In addition, the severity of cyanosis of the skin directly affects the state of the vascular wall.In the initial stage it is most often observed akrotsianoz lips that become unnatural bluish tint that clearly distinguished on the background color intact mucosa of the mouth and tongue.Next in frequency of localization of acrocyanosis is a change in color of the skin of the distal parts of the upper and lower extremities with a concomitant change in the nail plate.Rare localization akrotsianoticheskih changes that occur in extreme hemodynamic considered leather ears, chin and nose.
addition to discoloration of the skin at Acrocyanosis always reduces local skin temperature, so this category of patients is constantly complaining about the increased sensitivity of the skin in relation to temperature stimuli.Pathognomonic symptom of congestive heart failure, which in most cases combined with acrocyanosis, a local hyperhidrosis skin.
acrocyanosis is a fundamental difference of local distribution of the above symptoms that distinguish it from the diffuse form of cyanosis.Pain in the skin changes are not characteristic for acrocyanosis, but the majority of patients suffering from this disorder for a long time, said the frequent episodes of twitching of muscle fibers in the affected area, in some cases accompanied by unpleasant sensations.
In some situations, the visual manifestation of acrocyanosis accompanying the course of chronic cardiac pathology can simulate Raynaud's syndrome.Acrocyanosis principal difference in this situation is its resistance, regardless of external factors.Despite the fact that akrotsianoz seen as a sign of circulatory disorders, this pathology under any circumstances are not accompanied by the development of trophic disorders of the skin in the affected area, which is also its pathognomonic criterion.Accordingly, the main damage to the neurovascular bundle also observed a surge in the projection of skin changes is not compromised.
Due to the fact that acrocyanosis often observed in patients cardiological suffering from congestive heart failure, along with a change in color of the skin and the local temperature, a marked swelling of the affected areas with predominant localization in the distal lower extremities.
As a rule, the typical clinical symptoms can reliably establish the presence of the patient acrocyanosis, but in a difficult situation to detect latent form of this disease should be to test the impact of cold on the skin irritant.In the presence of a person of a violation of microcirculation, when exposed to even a slight cold stimulus notes marked blue skin, which has a limited location.Upon termination of exposure to cold stimulus color of the skin becomes accustomed normal hue.
In contrast to the adult patient population, acrocyanosis in newborns is not always a bad prognostic sign and can be observed even in healthy children, especially born prematurely.Localization akrotsianoticheskih usual manifestations are the foot, hand and nasolabial triangle.A characteristic feature of acrocyanosis in children in the neonatal period is its gain in the expression of anxiety, crying and overcooling.However, initial examination of the newborn child with signs akrotsianoticheskih changes of the skin, should be aware of severe cardiovascular birth defects, diagnosis which now is not easy.
Due to the fact that acrocyanosis is not an independent nosological form, specific treatment of specific pathological condition does not exist.Full elimination of signs of acrocyanosis is possible only in case of absolute cure the underlying heart disease, which was the provocateur circulatory disorders at the microcirculatory level.Even though that acrocyanosis, as a pathological symptom is rarely prone to rapid progression, this state needs in a timely symptomatic and prophylactic treatment, as its background may develop serious vascular disease.
as symptomatic treatment aimed at strengthening the vascular wall, a good positive effect have fortified medicinal products based on B vitamins in parenteral form.Good vasodilator has Nicotinic acid 0.015 g daily dose orally.
Patients suffering from long acrocyanosis, tolerate different types of external local treatment (grinding and compresses camphor ointment) and physiotherapy (ozocerite baths, mud therapy, diathermy and massage), after which point a significant improvement.
After manage to compensate for the state of hemodynamics in patients with chronic cardiovascular failure, it is necessary to recommend the use of this category of patients, drug preventive measures in the form of the systematic hiking and tempering procedures.Patients with acrocyanosis should avoid exposure to aggressive cold stimulus, which has a negative impact on the state of intradermal microcirculation.
In most situations, a good effect for the elimination of signs of acrocyanosis has sympathectomy, but this operational manual can not be included in the mandatory list of medical procedures.
Due to the fact that acrocyanosis is the external manifestation of vascular disease, a continuing nature, the constant use of drugs is unacceptable.In this situation, a good tool is a means of non-traditional folk medicine, both for external and for internal use (honey infusion, tincture of pumpkin seeds, bath with calendula and St. John's wort).