A nonatheromatous lesion involving arteries, veins, and nerves occurring in young males frequently leads to non-healing ulcers and gangrene. It is purely related to heavy smoking in males.
Causation:
Unknown
Predisposing factors
Usually begins between 20 to 40 years of age.
Almost confined to males.
Tobacco smoking or chewing is an important factor.
Lower limbs principally affected.
Pathology
It is probably an inflammatory condition. All three coats of arteries are inflamed, infiltrated with polymorphs and the lumen is obstructed by a clot.
A young male of 20 to 40 years of age comes with superficial, migratory, nodular phlebitis.
Nodules associated with cutaneous erythema and tender to touch.
Eventually, vasculitis and ischemic changes appear in the distal extremities such as legs or toe of legs or flinger of hand.
Signs / Symptoms
Pain severe, more on exertion (intermittent claudication), better at rest. May be associated with neuritis.
Cold extremities, tearing pain when exposed to cold (Raynaud's disease), blue, and finally red.
Trophic changes may develop.
Finally, gangrene may occur.
Superficial thrombophlebitis may develop.
Intense rubor(redness) of the feet even in the supine position.
Absent foot pulse.
Reduced or absent radial and/or ulnar pulse.
The skin becomes thin and shiny. Hair growth is reduced. Limb ulcers and gangrene are common complications, usually resulting in the need to remove the affected limb.
How to diagnose?
Buerger's disease can be imitated by a variety of other diseases, which cause a decrease in blood flow to the limbs. These other diseases must be ruled out through active evaluation, because their treatment is very different from Buerger's disease, and there is no effective treatment for this disease.
Blood tests for certain substances can rule out other conditions that may cause similar signs and symptoms. For example, blood tests can help rule out autoimmune diseases such as scleroderma or lupus, blood clotting disorders, etc.
Upper and lower extremity angiography can help diagnose Buerger’s disease. In an appropriate clinical setting, some angiographic results can be diagnosed as Buerger's disease. These findings include the appearance of arterial "corkscrews" caused by vascular damage, especially in the wrist and ankle area.
The collateral circulation creates the appearance of "tree roots" or "spider legs". Angiography may also show blockages (blocking) or narrowing (narrowing) in multiple areas of the arms and legs. Distal plethysmography can also produce useful information about the state of the digital loop. In order to rule out other forms of vasculitis (by excluding the intervention of atypical Buerger vascular areas), it is sometimes necessary to perform angiography of other body areas.
Treatment
Stop smoking
Mild massage to lower limbs
Proper care of feet,(Avoid trauma and extremes of temperature).
In ongoing cases, lumbar sympathectomy sometimes supportive. It diminishes vasoconstriction and expands the bloodstream to the appendage. It helps in recuperating and giving alleviating from the agony of ischemic ulcers.
Sidestep can some of the time be useful in treating appendages with helpless perfusion auxiliary to this infection. Utilization of vascular development factors and undifferentiated organism infusions have been showing guarantee in clinical examinations.
There might be an advantage of utilizing bone marrow-inferred immature microorganisms in recuperating ulcers and improving agony-free strolling distance, yet bigger, excellent preliminaries are required. Debridement is done in necrotic ulcers.
In gangrenous digits, removal is habitually required.
Above-knee and beneath-knee removal is infrequently required.
Streptokinase has been proposed as adjuvant treatment sometimes.
Prognosis
The prognosis is bad. But if amputation performs, this disease is not fatal.
What is the difference between TAO disease and Raynaud's disease?
Raynaud's is an uncommon condition that influences the veins, ordinarily in the fingers and toes.
The veins limited, or vasospasm, when stress is capable or the fingers or toes are presented to cold temperatures.
This narrowing of the vessels keeps blood from arriving at the influenced territory, causing the skin to seem white and blue.
When managing Raynaud's, even a brief or negligible temperature change can prompt an assault. For instance, venturing into a cooler can make the fingers become white.
TAO or Buerger's disease said above
Homeopathic medicines
Homeopathy believes in proper case-taking of a patient. Tuberculinum is a medicine that is very effective on this disease.
Arsenicum album and Carbo vegetabilis also very good medicines.
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