Reduced systolic blood pressure in fingers of patients with generalized scleroderma (acrosclerosis)

Segmental systolic blood pressure was measured on upper arm, wrist, proximal and middle pahlanx in 10 patients suffering from generalized scleroderma of the acrosclerosis type and in 5 normal. Systolic pressure was measured by the strain-gauge technique before and after abolition of sympathetic vasoconstrictor activity by local heating and by nerve block. Arm and wrist pressures were equal in the two groups, but a significant reduction in finger pressure was found in the patients. Finger pressure was unaltered after sympathetic blockade, both in the patients and in the normals. The pressure drop from wrist to finger in the patients suggests an increased flow resistance in the palmer arch and digital arteries which was probably not caused by an augmented sympathetic vasoconstrictor activity, as sympathetic blockade did not influence finger systolic pressure. Sympathectomy cannot be expected to relieve Raynaud's attacks in these patients.