Over the years we have come across several patients who were told that they suffer from Raynoud’s disease as well as hyperhidrosis. This is a very common mistake being made exposing the patient to unnecessary treatment modalities. The other problem is that it takes away attention from the real issue which is hyperhidrosis. A certain amount of patients, on top of their severe palmar hyperhidrosis / plantar hyperhidrosis also have clammy extremities which also are bluish / reddish in color. The explanation for this is overactive sympathetic chain activity.
In order to diagnose Raynoud’s disease a very simple test is necessary. This test is called Erythrocytes Sedimentation Rate (ESR). If it is normal, the likelihood that the patient has Raynoud’s is extremely low. Is it an extremely simple and cheap test. A person who is suffering from these symptoms should request this test right from the beginning.
The cold hands and feed (clammy) are also due to the overactive sympathetic chain which is causing narrowing of the blood vessels. If a patient does not have sweaty hands but only clammy extremities with discoloration (bluish, reddish) then sympathectomy is not recommended for them. The only indication now a days for thoracic or lumbar sympathectomy is the level of hyperhidrosis in the extremities. With the sympathectomies the patient will get warming of his color extremities and the discoloration will disappear. Those aforementioned improvements are not long lasting in regards to the warming affect and the improvement of the discoloration. With regard to the actual sweating there are life long improvements with high success rates. The recurrence rate is in the range of about 1%.