Dear Lisa -

Although I have not (yet) had to deal with the issue of skin lesions, there's a fair amount of literature out there on it. Let me first of all refer you to the following articles - and corresponding photos - that are listed on the RSDSA Medical Articles Archive page at http://www.rsds.org/2/library/articl...ive/index.html, under the heading of "Complications:"

Author: Goris RJA
Title: Skin Complications in RSD patients

Author: Greipp ME, Thomas AF.
Title: Skin Lesions Occurring in Clients with Reflex Sympathetic Dystrophy Syndrome. Source: Journal of Neuroscience Nursing. 1994;26:340-341.

Author: Webster GF, Schwartzman RJ, Jacoby, RA, Knobler RL, Uitto JJ.
Title: Reflex Sympathetic Dystrophy, Occurrence of Inflammatory Skin Lesions in Patients With Stages II and III Disease.
Source: Archives of Dermatology. 1991;127:1541-1544.

That said, I am personally quite familiar with the general case of the issue you raise, which falls under the heading of peripheral vascular abnormalities. For me, that's manifest by constriction of peripheral blood flow, to the point that it's often very difficult to (1) draw blood from my veins or (2) insert any form of a catheter wider than a 22-gauge needle, and that's getting fairly small. For a good article on that point, see, "Vascular Abnormalities In Reflex Sympathetic Dystrophy (CRPS I): mechanisms and diagnostic value," Gunner Wasner et al (incl. Prof. Dr. med. Ralf Baron), 124 Brain 587-599 (2001):

"In conclusion, it is suggested that, in CRPS I, unilateral inhibition of sympathetic vasoconstrictor neurones leads to a warmer affected limb in the acute phase. Secondary changes in neurovascular transmission may lead to vasoconstriction and cold skin in chronic CRPS I, whereas sympathetic activity is still depressed."

I would be happy to send a copy of this article to you or anyone else who may be interested in it. (At 491.48 KB it's too large to post as an attachment here.) Just drop me a pm with your email address.

Mike