Raynaud’s syndrome

Raynaud’s syndrome, or: Raynaud’s disease, is a rare disorder of the blood vessels. It usually manifests as vasospasms in the fingers and toes, causing reversible discomfort and colour changes in one or more digits (pallor, cyanosis, erythema, or a combination). Occasionally, other acral parts, such as nose and tongue, are affected.

The disorder may be primary or secondary. Primary and secondary forms are distinguished clinically, supported by vascular laboratory studies and blood testing. A thorough history and physical examination directed at identifying a causative disorder are helpful but rarely diagnostic. Laboratory testing to detect accompanying disorders includes blood tests: measurement of erythrocyte sedimentation rate (ESR), testing for antinuclear antibodies (ANA), rheumatoid factor, centromere antibodies, and Scl-70 antibodies.

Raynaud’s syndrome secondary to a connective tissue disorder may progress to painful digital gangrene; Raynaud’s syndrome secondary to scleroderma tends to cause extremely painful, infected ulcers on the fingertips.

Treatment of the primary form involves avoidance of cold, smoking cessation, and, if stress is a triggering factor, relaxation techniques or counseling. Drugs are used more often than behavioural treatments because of convenience. Treatment of the secondary form focuses on the underlying disorder.



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