Cryoglobulinemia –
RAYNAUD’s Disease – CAD (Cold Agglutinin Disease)
Cold Urticaria – Hives
Livedo Ritucilaris

This is a brief comparison of conditions or diseases that discolor the skin.  Especially when associated with cool or cold temperature exposures.  Some may seem to be related to CAD?  But are totally different in their lasting effect(s) and their actual accurate diagnosis.

CAD for instance is a blood/antibody attack upon the Red Blood Cells, that causes Red Blood Cells to clump together, and be destroyed (Hemolysis).  In the process the clumped Red Blood Cells block normal sized blood vessels, that are naturally smaller in the extremities.  Triggering skin discoloration and Hemolysis at the same time.  The other diseases/conditions listed do not typically result in excessive Hemolysis on their own.

Cryoglobulinemia (Precipitate)

CRYOGLOBULINEMIA   A Blood Disease is triggered by colder than body temperatures (98.6°F/37°C).  Which causes abnormal blood proteins to accumulate and block blood flow.

Cryoglobulinemia differs from CAD.  It does not destroy the Red Blood Cells as CAD does.  Cryoglobulinemia is a blood disease which is caused by abnormal blood proteins that bond together (“Precipitate”).  The bond is triggered by temperature.  This Precipitate then accumulates in blood vessels and restrict blood flow.  Triggering skin discoloration but not Hemolysis.  It dissolves when returned back to a normal temperature.   This has the potential to cause damage to skin, nerves, muscles, joints, and organs.

Protein bonding (“Precipitate”), is not the same as Red Cell Clumping (Agglutination).

RAYNAUD’s Disease (Vasospasm)

RAYNAUD’s Disease is a mechanical function that constricts normal blood vessels, to a smaller size, thus slowing the supply of blood.  Especially in the extremities.   Set off by temperature. Triggering skin discoloration, but not Hemolysis.

In Raynaud’s Disease, the body incorrectly limits blood flow to smaller arteries/blood vessels (Vasospasm).   This is not a CAD response.

Vasospasm refers to the sudden contraction of the muscular walls of an artery.  The contraction causes the artery to narrow and reduce the flow of blood.

Since Raynauds symptoms are caused by a constriction, the does not create hemolysis.  There is no associated anemia or lowered Hgb.

RAYNAUD’s Disease is a condition that causes some parts of the body to become numb and cold in response to cold temperatures or stress.  Visual symptoms are various skin discoloring ranges.  Splotches, red to dark colored skin, etc.

Without clinical testing, Raynauld’s is often confused with Cold Agglutinin Disease, or vice versa.

While some of the symptoms are similar, their cause/triggers are totally different.  Raynaud’s and CAD (Cold Agglutinin Disease) are not the same thing.

It takes specific testing to confirm either.  If you have an old diagnosis from many years ago based on observation only.   It would benefit you to seek out the latest clinical testing.  To confirm you actually have Raynaud’s or CAD.

The most common area affected are the extremities such as fingers and toes.

These conditions are often confused with each other, based on physical observation only.  Often sharing a common physical discoloration of the skin, often referred to as Raynaud’s, or “Raynaud’s Phenomenon”.  In the early stages, often misdiagnosed or assumed without proper and adequate testing.  These 3 diseases are uniquely different.

Not to say some of these individual diseases aren’t secondary to each other.  Or perhaps coexisting within the same patient.

Also see Acrocyanosis below.

To get an accurate diagnosis.  For perhaps a treatment plan, or lifestyle changes as a preventative.  It is highly recommended you seek out a highly rated Hematologist and complete all testing.  Do not make any assumptions based on observation only, or from a long-ago assumption from a doctor that did not pursue any diagnostic testing.

Cold Agglutinin Disease (Agglutination)

Cold Agglutinin Disease.  Temperatures triggers antibodies to attack the bodies Red Blood Cells.  These antibodies are an autoimmune condition that is not found in normal healthy, non-CAD individuals.  This attack causes Red Blood Cells to clump together (Agglutination).

Red Cell (Agglutination) is not the same as Protein Bonding (Precipitate).

When these antibodies attack Red Blood Cells, thinking the RBC’s are foreign invaders, similar to a virus.  These Red Cells clump together and actually get destroyed in the process.  In the naturally smaller blood vessels found in the extremities such as fingers, nose, etc.  These clumped Red Cells temporarily block the flow of blood.  The result is visible skin discoloration at various degrees.

Cold Agglutinin Disease often results in visual physical symptoms in the extremities that appear the same or similar to Raynaud’s and some of the other diseases/conditions that result in skin discoloration.

In Cold Agglutinin Disease, when this clumping is occurring (Agglutination), the Red Blood Cells are also being destroyed (Hemolysis).  Which can lead to anemic conditions, or lowered Hgb.  Patients with CAD normally experience a higher than normal Retic Rate.  Retic is the body’s natural response to replace excessive loss of Red Blood Cells.  Retic Rate can be measured via a blood test.


Cold Urticaria – Hives   Use the link for more details.

Cold Urticaria (ur-tih-KAR-e-uh) is a skin reaction, that appears within minutes after cold exposure.

Affected skin can develop various degrees of itchy welts (hives).

People can experience wide and varying degrees of symptoms.

Symptoms may be as minor as hives. On the more severe side of a reaction, people may experience low blood pressure, fainting, shock, and anaphylaxis reactions.

Symptoms can be short term.  In other cases the symptoms can last weeks or months.

People with this condition need to take preventive steps such as taking antihistamines with the blessing and dosage recommended by your doctor.  Avoid cold air and water.  Be acutely aware that swimming can trigger such a reaction, as well as damp skin, damp clothing, and exposures to wind and cold.

You should seek immediate medical attention if you suspect such a reaction.  Even more so if a reaction seems serious or long term.  Or you do not know what you are dealing with.



Acrocyanosis is another disease/condition that can be “Primary” or “Secondary.

Resulting in discoloration of the extremities.  Often described as “blueish” in color.

Raynaud’s, is often a cause of secondary acrocyanosis.

Acrocyanosis can be painful,  and can lead to tissue loss.

It is believed primary acrocyanosis is caused by constriction of the small blood vessels that deliver oxygen-rich blood to the extremities. This constriction may be due to cold temperatures, or other conditions.  (Very Similar to Raynaud’s).

This disease/condition alone, typically does not cause agglutination, Red Cell destruction, and anemic conditions.

Livedo Ritucilaris

Livedo Ritucilaris is often described as “mottled skin”, web-like discoloration of the skin.  Color discolorations ranging from red, blue, purple.  Some times in very dark colors.   Often a distinct web-like or lace-like pattern.

This is another disease/condition that is caused by reduced blood flood.  Often due to cold exposures.  But can be triggered by other things, including medications.

This disease/condition alone, typically does not cause agglutination, Red Cell destruction, and anemic conditions.