Vascular acrosyndromes constitute a common reason for physician visits. They are associated with connective tissue disease; for example, 90% of patients with scleroderma experience Raynaud's phenomenon. The rheumatologist must strive to establish the diagnosis, to identify a potential underlying cause, and to prescribe effective treatment when the symptoms are incapacitating. Raynaud's phenomen...

Raynauds phenomena (RP) is a commonly encountered clinical manifestation which may be primary or secondary to underlying disease. There is imbalance between vasoconstricting and vasodilating factors. Physical examination, nailfold capillaroscopy and immunological tests can differentiate primary from secondary RP. Treatment involves prevention of RP so that permanent ischemic damage i.e. gangren...

1. Evidence has been found that Northrop's phenomenon (so called by us) is produced in the digestion of casein or hemoglobin brought about by trypsin, papain, and pepsin either crude or crystalline in the presence of gelatin. 2. Anson's and Kunitz' methods permit the measure of proteolytic activity of any protease on casein or hemoglobin substrate in the presence of gelatin, even in very small ...

Figure 1. Ischemic ulceration and necrosis of left middle finger. DESCRIPTION A 35-year-old man presented with a 3-year history of episodic fingertip pain with associated discoloration triggered by cold exposure. His job required activities in a subzero walk-in freezer, which exacerbated pain and discoloration. The middle fingertip wound began spontaneously 3 months prior and worsened despite m...