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Raynaud phenomenon

Last reviewed: 5 Oct 2024
Last updated: 04 Oct 2024

Summary

Definition

History and exam

Key diagnostic factors

  • digit pain/discomfort
  • digital paresthesia
  • pallor of digits
  • red and/or blue discoloration of digits
  • dilated capillaries at nailbeds
  • well-defined discoloration
  • magnification of nailbeds
Full details

Other diagnostic factors

  • heartburn
  • dysphagia
  • puffy hands
  • tight skin
  • arthralgia
  • photosensitivity
  • oral/nasal ulcers
  • alopecia
  • butterfly rash
  • sclerodactyly
  • telangiectasia
  • pleuritic chest pain
  • digital ulcers
  • digital pits
  • digital tuft resorption
  • gangrene of fingertip/finger
  • raised painful red lesions on finger tips
  • autoamputation
Full details

Risk factors

  • female
  • family history
  • connective tissue disease
  • use of certain drugs
  • vibration injury
  • Buerger disease
  • prolonged cold exposure/frostbite
  • colder climate
  • smoking
  • ischemia
  • migraine
  • glaucoma
Full details

Diagnostic tests

1st tests to order

  • clinical diagnosis
  • antinuclear antibody
  • CBC
  • erythrocyte sedimentation rate
  • C-reactive protein
  • urinalysis
Full details

Tests to consider

  • capillaroscopy
Full details

Treatment algorithm

ACUTE

severe secondary RP: critical ischemia with digital ulcers or threatened digital loss

ONGOING

primary or mild secondary RP

Contributors

Authors

Janet Pope, MD, MPH, FRCPC
Janet Pope

Professor of Medicine

Division of Rheumatology

Department of Medicine

University of Western Ontario

Schulich School of Medicine and Dentistry

Head

Division of Rheumatology

St. Joseph's Health Care

London

Ontario

Canada

Disclosures

JP has been reimbursed for consulting with several pharmaceutical manufacturers unrelated to Rayaud phenomenon. JP’s institution receives research grants from BMS, Janssen, and Seattle Genetics. She has acted as a consultant for AbbVie, Amgen, AstraZeneca, BI, BMS, Celltrion, EMERALD, Frensenius Kabi, GSK, Janssen, JMP, Lilly, Mallinckrodt Pharmaceuticals, Mitsubishi Tanabe Pharma, Novartis, Organon, Pfizer, Sandoz, Samsung, and Viatris. JP is a speaker and advisory board member for AbbVie, Amgen, AstraZeneca, BI, BMS, Frensenius Kabi, GSK, Janssen, JMP, Lilly, Novartis, Organon, Pfizer, Sandoz, UCB, and Viatris. She receives no patents or royalties. JP is an author of a number of references cited in this topic.

Peer reviewers

Elena Schiopu, MD

Professor of Medicine

Rheumatologist

Medical College of Georgia at Augusta University

Charlie Norwood Veterans Affairs Medical Center

Augusta

GA

Disclosures

ES declares that she has no competing interests.

Ariane L. Herrick, MD FRCP

Reader in Rheumatology and Consultant Rheumatologist

Musculoskeletal Research Group

University of Manchester

Manchester

UK

Disclosures

ALH has been a paid speaker for Actelion; a consultant for Actelion and Pfizer; and an investigator in studies sponsored by Actelion, Mediquest, and United Therapeutics. ALH is an author of a number of references cited in this topic.

Bridget Griffiths, MB ChB, MD, MRCP(UK)

Consultant Rheumatologist

Department of Rheumatology

Freeman Hospital

Newcastle upon Tyne

UK

Disclosures

BG declares that she has no competing interests.

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