Overview of Raynaud phenomenon
Raynaud phenomenon is caused by vasospasm of the digits, usually in response to cold exposure or stress. It presents as episodic blanching, cyanosis, and erythema of the digits. Patients often experience pain. While Raynaud phenomenon is a common condition, particularly in females, it should be differentiated from the more common complaint of diffusely cold and/or mottled hands that is not associated with a disease process. In the latter situation, the hands recover quickly and evenly.
Raynaud phenomenon can be a primary condition or can occur secondary to a connective tissue disease (eg systemic sclerosis) or other disease (eg atherosclerosis, malignancy). Suspect an underlying connective tissue disease in a patient with other common clinical features of a connective tissue disease (eg arthralgia, fatigue), an elevated erythrocyte sedimentation rate (ESR), a positive antinuclear antibody (ANA), and abnormal nailfold capillaries on inspection under magnification (eg dilation, capillary dropout, haemorrhage).
Secondary Raynaud phenomenon may cause digital ischaemia (see Digital ischaemia in people with Raynaud phenomenon for management advice).