Highlights & Basics
- Raynaud phenomenon (RP) is common, affecting between 3% and 5% of the population.
- The diagnosis is made clinically: digits turn white (pallor) then blue with deoxygenation and/or red with reperfusion; pallor is well demarcated.
- Primary RP often needs no pharmacologic treatment. Keeping warm, smoking cessation, regular exercise, and avoiding stress are recommended. Pharmacologic treatment can be considered in people with mild disease who do not respond to lifestyle measures. Potential treatment options include calcium-channel blockers, angiotensin-II receptor antagonists, selective serotonin-reuptake inhibitors (SSRIs), topical nitrates, alpha-blockers, and ACE inhibitors.
- Secondary RP can be severe, especially when associated with systemic sclerosis (SSc). Other underlying conditions, exposures, or drugs can also cause secondary RP. In severe secondary RP, calcium-channel blockers, phosphodiesterase-5 inhibitors, prostacyclins, atorvastatin, and bosentan are potential treatment options, with only the most severe cases warranting surgical intervention.
- Complications in secondary RP include severe digital ischemia, gangrene, digital ulcers, and infection.
Quick Reference
History & Exam
Key Factors
Other Factors
Diagnostics Tests
Treatment Options
Definition
Epidemiology
Etiology
Pathophysiology
Images
Cyanotic Raynaud phenomenon (RP) in a patient with mixed connective tissue disease
Well-demarcated pallor of the 3rd finger in a patient with primary Raynaud phenomenon (RP)
Digital infarcts and nailfold changes
Digital pits on the 3rd finger of the left hand
Digital ulcer in a patient with secondary Raynaud phenomenon (RP)
Raynaud phenomenon (RP) and inflammatory arthritis with sclerodactyly distal to the proximal interphalangeal joints
Swollen/puffy fingers in a patient with secondary Raynaud phenomenon (RP)
Secondary Raynaud phenomenon (RP) with sclerodactyly
Visible dilated capillaries at the nailbed
Citations
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