Raynaud's phenomenon

Raynaud's 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 pharmacological treatment. Keeping warm, smoking cessation, regular exercise, and avoiding stress are recommended.

Secondary RP can be severe, especially when associated with scleroderma. Other connective tissue diseases, malignancy, and atherosclerosis may also be the underlying cause.

In secondary RP, calcium-channel blockers, angiotensin receptor antagonists, ACE inhibitors, SSRIs, systemic and topical nitrates, phosphodiesterase-5 inhibitors, and prostacyclins are potential treatment options.

Complications in secondary RP include severe digital ischaemia, gangrene, digital ulcers, and infection.

Pain relief may be an important adjunctive treatment. There are few data for complementary therapies.

Raynaud's phenomenon (RP) is characterised by vasospasm that causes digits to change colour to white (pallor) from lack of blood flow, usually brought on by cold temperatures. Affected areas subsequently turn blue due to de-oxygenation and/or red due to reperfusion. It can be a painful condition and can lead to complications.