Pathological changes of finger and toe in patients with vibration syndrome

Pathological findings of the fingers and toes were studied in finger and toe skin specimens from 21 male patients with vibration syndrome and 13 referent male cadavers. Thickening of the medial muscle layer of small arteries or arterioles, and increase of collagen fibers in the connective tissues, especially in perivascular regions, were noted in not only the finger but also the toe in patients with vibration syndrome. The ratio of the media/external diameter in the finger and toe was significantly greater in the patients than in the referents, even in the patients who had operated chain saws, bush cutters or grinders and had not been exposed to vibration of the foot directly. And the ratio in the finger was approximately parallel with that in the toe in the same subject. The present findings pathohistologically confirmed the existence of circulatory disturbances in the feet as well as the hands. The medial thickening of arteries and perivascular fibrosis in the toe can result from not only direct vibration exposure of the foot, but also long-term repeated vasoconstriction and circulatory disturbances in the foot through the activation of the sympathetic nerve system caused by hand-arm vibration.