Water‐immersion wrinkling is due to vasoconstriction

@article{WilderSmith2003WaterimmersionWI,
  title={Water‐immersion wrinkling is due to vasoconstriction},
  author={Einar P. V. Wilder-Smith and Adeline W L Chow},
  journal={Muscle \& Nerve},
  year={2003},
  volume={27}
}
The underlying mechanism of the water‐immersion skin wrinkling test, which is used as a test of sympathetic nerve function, remains elusive. We investigated changes of blood circulation in the hand occurring with water‐immersion wrinkling by measuring the velocity of ulnar and digital artery blood flow, and of digit skin blood flow, in healthy subjects before and during wrinkling. Wrinkling was accompanied by significant reduction in blood flow velocity in all vessels, with a maximum in digital… 

Water immersion wrinkling

The physiology of water immersion wrinkling is discussed and its potential as an indicator of limb sympathetic dysfunction is explored and digital blood flow or volume changes are suggested as better endpoints.

Paradoxical response to water immersion in replanted fingers

The paradoxical cutaneous vasodilatation and absence of wrinkling in the denervated fingers suggests that sympathetic innervation is important in water-immersion skin wrinkling.

Water Immersion-Induced Skin Wrinkling: More Accurately Reflects Neurovascular Coupling rather than Just Neural Function

  • J. Lazar
  • Medicine
    Archives in Neurology & Neuroscience
  • 2019
This work proposes WISW to more accurately reflect neurovascular coupling and suggests it could be a measure of peripheral sympathetic function, to reflect autonomic function and small fibre neural function.

Characterizing the Water Immersion Finger Wrinkling Test in Healthy Subjects

An attempt to describe the WISW test in terms of optimal duration required for water immersion, inter-observer variabil i ty on the outcome measures, different methods to assess the wrinkling induced by water immersion and the effect of age and gender on the rate of formation of water immersion induced wrinkles.

A proof-of-concept assessment in healthy volunteers of stimulated skin wrinkling to determine the presence or absence of digital nerve blockade

A proof-of-concept study to examine if blinded observers could differentiate the presence or absence of a digital nerve block in healthy volunteers by assessing photographs of skin-wrinkling taken during the use of the SSW test with EMLA cream showed that observers identified significant differences in wrinkling following the application of the EML a cream between blocked and unblocked digits at all time intervals.

A comparative analysis of water immersion induced hand wrinkling in dermatological diseases

There is a significant variation in the water immersion induced hand wrinkling pattern in patients with Dermatoses like Psoriasis, Vitiligo, and Hand Dermatitis due to structural alterations in the epidermis and dermis and Estrogen and the sympathetic nervous system play a significant role in water immersion-induced wrinkling.

Evaluation of the finger wrinkling test: a pilot study

The finger wrinkling test can be used as a screening test before tilt table testing and visual evaluation of wrinkling is still superior to digital analysis of photographs.
...

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