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Raynaud's disease. Tongue showing a loss of colour due to Raynaud's disease (vasospasm). The tongue's small arteries have suddenly constricted, stopping the blood supply. Vasospasm occurs in response to cold, although it may be a symptom of the autoimm- une disorder scleroderma (systemic sclerosis). The tongue is rarely affected, more commonly it is the fingers and toes that whiten and become painful. In rare cases the arterial walls thicken, perman- ently reducing blood flow and causing ulcers or even gangrene (tissue death). Treatment is through keeping the extremities warm, stopping smoking and vasodilator drugs. An operation to cut the nerve that makes the arteries spasm may be necessary.
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