on warming the parts I is a lunctional vaso and no treatmeni ercet warm clothing is requind un Is associated with arteriolar constriction associated with dilatation of cutaneous subpapillary venous p is common in hoth sexes and in tecnagers
CHILBLAINS Ilere alter exposure to cold localized vasoconstriction oecurs in the fingers and toes associated with vasodilatation beyond the zone of constriction Symptomatic treatment is required as ERYTHROCYANOSIS it is usually seen in young women with obesity Bluish red atches occur in the legs associated with burning and itching
Rarely, nodules are forned. It appears in winter and clears up during the summer months
Treatment is symptomatic but for severe cases sympathectomy may be tried ERYTHROMELALGIA
(Erythermalgia)
This is a condition of paroxysmal bilateral vasodilatation of unknown cause. Both sides are affected. The primary form
is a rare disease. Secondary form occurs in Gout Hypertension, Polycythaemia vera and in different neurologic
disorders. Symptoms include bilateral burning distress usually at night when the patient is under warm clothes or after
exercise, There is profuse sweating in involved areas. No finding is present in between attack. The vessels of the lower
limbs dilate and pulsate vigorously, due to this, the lower limbs become red and painful. On raising the lower limbs
there may be relief of pain. Aspirin may be very much beneficial but in severe cases section of peripheral nerve or
sympathectomy may be tried.

CARDIAC TUMOUR

Primary tumours of heart may occur but they are extremely rare. Secondary tumours are relatively common. Of different
primary tumours commonest being Myxoma (benign) and Sarcoma (malignant). Angiosarcoma and Rhabdomyosarcoma
are common.

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