Shiny soles plus Raynaud's Phenomenon in feet secondary to SFN damage?
 

Does anyone here have smooth, shiny (polished looking) soles with Raynaud's in their feet? This is after several years of small fibre neuropathy affecting all peripheries and my face? I'm slightly concerned that I may have peripheral vascular disease alongside my confirmed Sjogrens Syndrome.

I have this and it is secondary to my SFN. I believe PAD causes terrible leg pain when walking, doing activity, etc. Sounds more like manifestation of your neuropathy.

Thanks this is very reassuring. I do have terrible pain in my legs and arms during the night or while resting. It's throbbing and very deep in my calves, shins, knees and feet and is rather different to the SFN burning pain I suffered from for a few years. But the worst of this pain was in my soles so it makes some sense that this is now manifesting as shine.

I fret because my mum died prematurely from severe Atherosclerosis and I have the early clinical signs of this too - hence my question. I also have unexplained weakness in my arms and hands while resting. But I know I have sustained damage in my feet from the SFN so this is hopefully the culprit for the shininess and Raynauds attacks.

I'm also being checked for possibly Scleroderma and Vasculitus so these are possible culprits for my leg and arm pain too. My EMG and NCS were normal a few months ago so I was wondering if all this could relate to poor circulation caused by diseased arteries. I will see a podiatrist in a few weeks and he says he can tell if this is the case. My feet are fairly numb these days as a result of the SFN.

I'm sure there must be loads of overlap. I have shiny feet and sometimes hands. It's in the front of my feet. For me I'm sure that's the sfn damage to my skin making it thinner, more translucent and therefore shinier. Thin damaged skin (which sfn will cause) is going to look shiny in places if it's bad enough.
My feet feel like ice blocks to touch but burn sensation wise.
I have this weakness severely. I know this symptom you describe. Sometimes so bad it takes everything I have not to lie down all day. My legs are real bad. Autoimmune action is known to cause horrendous fatigue. If it feels like more than that to you - mine certainly is more than this - then it could be lots of other things. Nerve damage at a different level to sfn, myositis, or mitochondrial disorders are key possible culprits. It could also be neither. My research and discussions with neuro keep coming back to these 3 possibilities.

I have both shiny feet and soles, only after the SFN.

Thanks Joanna. My nerve conduction studies and EMG showed nothing at all so it's not Myositis for me. I think it must be SFN but I'm a bit baffled by the colour changes in feet which are clearly Raynauds related. I don't get this much in my hands - very occasionally my fingers turn bright white but it's not usually weather related. Toes and soles regularly turn luminous white and it is weather related. This is what makes me so confused about the pain - is it SFN or is it my dodgy circulation/ vascular/ mitochondrial ? It goes if keep moving but is horribly painful when I'm still.

I fret because both my parents had similar issues and both died suddenly of cardiac arrest at 73 years old. My mum was found by the coroner to have severe Atherosclerosis. She had unnamed circulation issues and similar weakness latterly along with vascular dementia. My dad had a rare type of heritary late onset diabetes. Not a great legacy!

Can SFN cause Raynauds do you know - or visa versa?

I have profound PN in my legs, and SFN in my upper body.

The soles of my feet became very shiny, my toes are purple because the nerve damage made blood flow to my toes restricted. Hot water will turn my toes completely white.

Sometimes one foot will be ice cold and the other rosy pink and warm. My toes will turn white. Usually both feet are icy cold and have to wear sock to bed.

Your neuropathy of whatever kind is causing the problems you have.

I don't have these problems in my hands, by the way.

But I do have SFN in my hands, and fingers and finger tips.

I take Gabapentin and it stops the pain, burning, itching and stabbing sensation in my scalp, face, lips, tongue, neck, arms hands and fingers.

Best wishes! Hugs, ElaineD

Thanks Elaine - I was sure it must be Raynauds but what you describe is identical to mine including hot water, hands, fingertips and even my face. So I guess if yours is neuropathic rather than vascular then mine must be too. Although if I google pics of Raynauds in feet it's identical to how mine appears so maybe SFN causes secondary Raynauds? Do you also have a connective tissue disease? I couldn't remotely tolerate Gaberpentin or any of the nerve symptom treatments sadly.

Small fiber neuropathy--
 

--can also involve dysfunction of the small autonomic nerves that help to control blood pressure, circulation, even the rate at which food passes through the intestinal tract.

It is not unusual for those with small-fiber neuropathy to have some degree of autonomic dysfunction, though it usually doesn't rise to the level of full blown dysautonomia. Often, it is subtle (and, as the researchers say, "subclinical".)

See:

Autonomic Differential Diagnosis

Small Fiber Sensory

Pain Differential Diagnosis

Thanks. I'm all too aware of this mild dysautonomia having been told by my neurologist that I probably have what she calls "mild ganglionopathy" - a form of autonomic dysfunction associated with my confirmed Sjögren's Syndrome (i.e. not idiopathic) alongside presumed SFN. I have GI problems at both ends and don't sweat appropriately, suffer sexual disfunction and cranial neuropathy - and have disequillbrium and tinnitus - all apparently caused by proprioceptin issues as part of the presumed SFN and Ganglionopathy of my diagnostically confirmed Sjögren's. An audiologist and opthamologist have both recently confirmed that my issues are most probably neurological as part of my rheumatic disease.

So the thing I'm really asking about is whether this sometimes includes a vasospastic process, if a person has colour and skin density changes in their digits and extremities - such as I have and ElaineD has described? And does this come under the heading of secondary Raynauds Phenomenon or not? Or is a different clinical process involved in causing these colour changes as part of SFN to the process involved in secondary Raynauds Phenomenon to advanced SFN? I'm aware that both can lead to ulcerations and loss of digits/ gangrene at their most severe - so what is the difference, if any, between these two conditions?

I'm still very confused about this and am being assessed for possible Scleroderma so it is important to me that I get to the bottom of this I feel. My sense is telling me, after these replies, that my problems are neuropathic and autonomic but this has not yet been histologically or physiologically confirmed. The first rheumatologist thought SFN but skin biopsy did not confirm. Then my GP and an eminent rheumatology professor told me three years ago that t was secondary Raynauds rather than peripheral neuropathy.

Now a second neurologist is saying it's SFN with gangliopathy, but says tests are not available where I live and anyway aren't necessary because my description and Sjögren's diagnosis are enough to go by. They aren't enough for me though - I like hard evidence rather than presumed diagnoses!

And I'm still none the wiser I admit but I worry most about atherosclerosis/ PAD as a third alternative possibility because of my family history.