Raynaud’s Phenomeon

An exaggerated physiological response to cold exposure or emotional stress where the extremities turn white (ischaemia) then blue (deoxygenation) then red (reperfusion), is called Raynaud’s phenomenon.¹

Causes of a Raynaud’s phenomenon:

Although the vast majority of RP is primary (idiopathic, PRP), RP can be secondary to a number of different conditions, including connective tissue disease.¹

Primary (Raynaud’s Disease)

• > 50%
• Female > Male (5:1)

Secondary to:

• Connective tissue disease
  • scleroderma (80-90%) – presenting symptoms in 30%
    • 95% with CREST syndrome → Raynaud’s
    • 75% systemic symptoms → Raynaud’s
  • Systemic Lupus Erythematosus (20%)
  • Rheumatoid arthritis
  • Dermatomyositis / polymyositis (30%)
• arterial occlusive disease
  • atherosclerosis extremities – Males > 50 years
  • thromboangiitis obliterans – young male smokers
  • acute arterial occlusion
  • thoracic outlet syndrome
• pulmonary hypertension
• neurological disorders
• blood dyscrasias
  • cold agglutinins, cryoglobulinemia, myeloprolipherative disease, Waldenstrom’s Macroglobulinaemia
• trauma – vibrational injury, electric shock, cold injury
• drugs
  • ergots
  • methysergide
  • beta-blockers
  • chemotherapy – bleomycin, vinblastine, cisplatin
• neurological disorders
  • intervertebral disc disease
  • syringomyelia
  • spinal cord tumours
  • stroke
  • Polio
  • carpal tunnel syndrome

Herrick, Ariane L. “Evidence-based management of Raynaud’s phenomenon.” Therapeutic advances in musculoskeletal disease vol. 9,12 (2017): 317-329. doi:10.1177/1759720X17740074