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J R Soc Med. 1994 July; 87(7): 377–381.
PMCID: PMC1294645

Cutaneous nerve fibre depletion in vibration white finger.

Abstract

Vibration white finger or hand-arm vibration syndrome is the episodic blanching of the fingers in response to cold occurring in those who work with hand held vibrating tools. Clinically the condition differs from primary Raynaud's phenomenon as persistent paraesthesiae and pain are common in the hands and arms and these occur independently from the 'white attacks'. Symptoms can become severe enough to warrant a change of occupation. Industrial compensation may be awarded for vibration white finger but, at present, no simple or reliable objective diagnostic test is available. Calcitonin gene-related peptide (CGRP) is a neuropeptide with powerful vasodilator properties. A deficiency of immunoreactive CGRP nerve fibres has been previously demonstrated in the digital cutaneous microvasculature of patients with primary and secondary Raynaud's phenomenon with the distribution and quantity of other types of nerve fibres not being significantly altered. To determine if the innervation of the cutaneous microvasculature in vibration white finger was also abnormal skin biopsy samples from the fingers of 15 patients with vibration white finger, six healthy age matched controls who worked with vibrating machinery and 26 healthy age matched controls who were heavy manual workers without exposure to vibrating machinery were examined by immunohistochemistry. To try to correlate any histological abnormalities with clinical neurological deficit sensory nerve conduction studies have so far been performed in six patients with vibration white finger.(ABSTRACT TRUNCATED AT 250 WORDS)

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Selected References

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  • Bunker CB, Terenghi G, Springall DR, Polak JM, Dowd PM. Deficiency of calcitonin gene-related peptide in Raynaud's phenomenon. Lancet. 1990 Dec 22;336(8730):1530–1533. [PubMed]
  • Karanth SS, Springall DR, Kuhn DM, Levene MM, Polak JM. An immunocytochemical study of cutaneous innervation and the distribution of neuropeptides and protein gene product 9.5 in man and commonly employed laboratory animals. Am J Anat. 1991 Aug;191(4):369–383. [PubMed]
  • Terenghi G, Bunker CB, Liu YF, Springall DR, Cowen T, Dowd PM, Polak JM. Image analysis quantification of peptide-immunoreactive nerves in the skin of patients with Raynaud's phenomenon and systemic sclerosis. J Pathol. 1991 Jul;164(3):245–252. [PubMed]
  • Bull HA, Bunker CB, Terenghi G, Springall DR, Zhao Y, Polak JM, Dowd PM. Endothelin-1 in human skin: immunolocalization, receptor binding, mRNA expression, and effects on cutaneous microvascular endothelial cells. J Invest Dermatol. 1991 Oct;97(4):618–623. [PubMed]
  • Welsh CL. The effect of vibration on digital blood flow. Br J Surg. 1980 Oct;67(10):708–710. [PubMed]
  • Harada N, Kondo H, Kimura K. Assessment of autonomic nervous function in patients with vibration syndrome using heart rate variation and plasma cyclic nucleotides. Br J Ind Med. 1990 Apr;47(4):263–268. [PMC free article] [PubMed]
  • Nakamoto M. Responses of sympathetic nervous system to cold exposure in vibration syndrome subjects and age-matched healthy controls. Int Arch Occup Environ Health. 1990;62(2):177–181. [PubMed]
  • Une H, Esaki H. Urinary excretion of adrenaline and noradrenaline in lumberjacks with vibration syndrome. Br J Ind Med. 1988 Aug;45(8):570–571. [PMC free article] [PubMed]
  • Olsen N, Petring OU. Vibration elicited vasoconstrictor reflex in Raynaud's phenomena. Br J Ind Med. 1988 Jun;45(6):415–419. [PMC free article] [PubMed]
  • Bovenzi M. Cardiovascular responses of vibration-exposed workers to a cold provocation test. Scand J Work Environ Health. 1986 Aug;12(4 Spec No):378–381. [PubMed]
  • Gemne G, Pyykkö I, Starck J, Ilmarinen R. Circulatory reaction to heat and cold in vibration-induced white finger with and without sympathetic blockade--an experimental study. Scand J Work Environ Health. 1986 Aug;12(4 Spec No):371–377. [PubMed]
  • Murata K, Araki S, Maeda K. Autonomic and peripheral nervous system dysfunction in workers exposed to hand-arm vibration: a study of R-R interval variability and distribution of nerve conduction velocities. Int Arch Occup Environ Health. 1991;63(3):205–211. [PubMed]
  • Cannon LJ, Bernacki EJ, Walter SD. Personal and occupational factors associated with carpal tunnel syndrome. J Occup Med. 1981 Apr;23(4):255–258. [PubMed]
  • Chatterjee DS, Barwick DD, Petrie A. Exploratory electromyography in the study of vibration-induced white finger in rock drillers. Br J Ind Med. 1982 Feb;39(1):89–97. [PMC free article] [PubMed]
  • Alaranta H, Seppäläinen AM. Neuropathy and the automatic analysis of electromyographic signals from vibration exposed workers. Scand J Work Environ Health. 1977 Sep;3(3):128–134. [PubMed]
  • Araki S, Yokoyama K, Aono H, Murata K. Determination of the distribution of nerve conduction velocities in chain saw operators. Br J Ind Med. 1988 May;45(5):341–344. [PMC free article] [PubMed]
  • Takeuchi T, Futatsuka M, Imanishi H, Yamada S. Pathological changes observed in the finger biopsy of patients with vibration-induced white finger. Scand J Work Environ Health. 1986 Aug;12(4 Spec No):280–283. [PubMed]
  • Vathenen AS, Cooke NJ. Home peak flow meters. BMJ. 1991 Mar 30;302(6779):738–738. [PMC free article] [PubMed]
  • Gibson SJ, Polak JM, Giaid A, Hamid QA, Kar S, Jones PM, Denny P, Legon S, Amara SG, Craig RK, et al. Calcitonin gene-related peptide messenger RNA is expressed in sensory neurones of the dorsal root ganglia and also in spinal motoneurones in man and rat. Neurosci Lett. 1988 Sep 12;91(3):283–288. [PubMed]
  • Wimalawansa SJ, Morris HR, MacIntyre I. Both alpha- and beta-calcitonin gene-related peptides are present in plasma, cerebrospinal fluid and spinal cord in man. J Mol Endocrinol. 1989 Nov;3(3):247–252. [PubMed]
  • Nelson MT, Huang Y, Brayden JE, Hescheler J, Standen NB. Arterial dilations in response to calcitonin gene-related peptide involve activation of K+ channels. Nature. 1990 Apr 19;344(6268):770–773. [PubMed]
  • Wallengren J, Ekman R, Sundler F. Occurrence and distribution of neuropeptides in the human skin. An immunocytochemical and immunochemical study on normal skin and blister fluid from inflamed skin. Acta Derm Venereol. 1987;67(3):185–192. [PubMed]
  • Bunker CB, Foreman JC, Dowd PM. Digital cutaneous vascular responses to histamine and neuropeptides in Raynaud's phenomenon. J Invest Dermatol. 1991 Mar;96(3):314–317. [PubMed]
  • Bunker CB, Coulson ML, Hayes NA, Dowd PM, Foreman JC. Further studies on the actions of endothelin-1 on blood flow in human skin. Br J Dermatol. 1992 Aug;127(2):85–90. [PubMed]

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