PERIPHERAL VASCULAR DISEASES 



I243 



A P P E N D 1 X 



CLASSIFICATION OF PERIPHERAL VASCULAR DISEASE 



Diseases Affecting Primarily the Arteries and Arterioles 



I. FUNCTIONAL CONDITIONS 



A. Vasoconstrictor 



1 . Raynaud's syndrome (primary Raynaud's disease) 



2. Raynaud's syndrome (secondary) 



a. Traumatic vasospastic syndrome 



b. Neurovascular mechanisms 

 (1) Shoulder girdle syndromes 



(a) Scalenous amicus 



(b) Cervical rib 



1 c 1 Costoclavicular 



(d) Hyperabduction 



(e) Thoracic outlet 



(f) Malposition 



(g) Pectoralis minor 

 1 2 I Spondylitis 



; 1 Neuritis 



c. Secondary to organic vascular disease 

 (1) Arteriosclerosis 



1 j 1 Syphilitic arteritis 



(3) Thromboangiitis obliterans 



(4) Thrombotic or embolic occlusion 



(5) Other occlusive arterial disease 



d. Secondary to intoxications 

 ( 1 ) Arsenic 



j 1 Ergot 



(3) Lead 



(4) Nicotine 



(5) Tobacco 



e. Scleroderma and acrosclerosis 



f. Miscellaneous mechanisms (e.g., rheumatoid 

 arthritis, lupus erythematosus, cold injury, and 

 other factors listed in Category 5 below) 



3. Acrocyanosis 



4. Livedo reticularis 



a. Idiopathica 



b. Svmptomatic livedo reticularis 



(1) Questionable factors 



Rickets, mongolism, various endocrin- 

 opathies, malnutrition, varicose veins, 

 other peripheral vascular diseases, infec- 

 tious diseases, intoxications, congenital 

 vascular defects, ectodermal abnormalities, 

 cirrhosis of the liver and other unusual 

 diseases, and neural disorders 



(2) Probable factors 



1 a ) Hypertension 



(b) Nervousness and emotional instability 



(c) Arsenic or lead poisoning (?) 



(3) Purported causes 



(a) Tuberculosis 



(b) Syphilis 



(c) Periarteritis nodosa and allergic cu- 

 taneous vasculitis 



c. Cutis marmorata 



5. Vasospasm, secondary to 



a. Lesions of peripheral nerves 



b. Lesions of brain and spinal cord including polio- 

 myelitis, prolapsed nucleus pulposus, hemiplegia, 

 tumors, multiple sclerosis, epileptic equivalent, 

 spinal bifida, spinal arthritis, lesions of midbrain 

 and internal capsule, etc. 



c. Thrombophlebitis 



d. Embolism 



e. Thrombosis 



f. Trauma 



(1) Posttraumatic reflex sympathetic dystrophy 



(2) Major causalgia 



(3) Minor causalgia 



(4) Sudeck's atrophy 



(5) Posttraumatic osteoporosis 



(6) "Vibrating-machine disease" 



(7) Shoulder-hand syndrome 



(8) Crutch arteritis 



(9) Metabolic, adynamic and hormonal, includ- 

 ing rheumatoid arthritis, malnutrition and 

 asthenia, terminal rheumatic heart disease, 

 hypothyroidism, castration, menopause, hy- 

 poglycemia, Addison's disease, polycythemia, 

 cold hemagglutination and cryoglobulins, 

 leprosy, etc. 



B. Vasodilator 



1 . Erythromelalgia, primary 



2. Erythromelalgia, secondary to 



a. Polycythemia vera 



b. Arteriosclerosis 



c. Thromboangiitis obliterans 



d. Hypertension 



e. Miscellaneous factors: trauma, gout, frostbite, 

 immersion foot, trenchfoot, infectious diseases, 

 heavy metal poisoning, etc. 



II. ORGANIC CONDITIONS (STRUCTURAL) 



A. Occlusive [organic) 



1. Arteriosclerosis 



a. Atherosis 



b. Atherosclerosis 



c. Atherosclerosis obliterans 



d. Medial ( Monckeberg's) arteriosclerosis 



e. Arteriolosclerosis and hypertensive ischemia 



f. Combined 



2. Thromboangiitis obliterans 



3. Arteritis (inflammatory diseases) and arteriolitis 



a. Disseminated arteritis 



b. Erythema induratum 



c. Erythema nodosum 



d. Nodular panniculitis 



e. Nodular vasculitis 



f. Temporal arteritis 



g. Syndromes of necrotizing and/or allergic vas- 

 culitis 



(1) General syndromes 



(a) Purpura rheumatica 



(b) Schonlein-Henoch syndrome 



(c) Allergic angiitis 



(d) Anaphylactoid purpura 



(e) Necrotizing vasculitis 



(f) Periarteritis nodosa of hypersensitivity 



