[The determination of the thermal threshold in subjects with Raynaud's disease. A preliminary report of 2 clinical cases]

Abstract

Background: The onset of Raynaud's phenomenon is mainly provoked by cold stimuli which, in patients affected by Raynaud's disease, are milder than those able to provoke the same phenomenon in healthy subjects. Therefore, it is reasonable to theorize the existence of a "thermal threshold", below which it is more likely for a Raynaud's phenomenon to be provoked. The aim of this investigation is to determine whether a thermal threshold in Raynaud's disease exists and if it can be used as a practical tool for preventing the complications of Raynaud's disease (digital gangrene and ulcers), whose onset is strictly related to the frequency of the phenomena.

Methods: Two patients affected, respectively, by slight Raynaud's phenomenon secondary to peripheral neuropathy (Case 1), by severe Raynaud's phenomenon associated with mixed connective tissue disease (Case 2), were asked to write a note about the phenomena and the days of their onset, within a period of three months. Afterwards, all data were related to the daily ground maximum temperature occurred in the period of study.

Results and conclusions: These preliminary results show an interesting correlation between this new parameter and the clinical data, the thermal threshold being higher in more severe cases. It was equal to 22 degrees C in the patient affected by slight phenomenon (Case 1), and equal to 27 degrees C in the severe phenomenon (Case 2). This method for evaluating the thermal threshold in these two cases of Raynaud's disease (the greater the figure, the more severe the case) allowed both the clinical assessment of the pathology and the prevention of secondary complications.