Raynaud’s disease causes episodes of vasospasm during conditions of emotional stress or extreme cold climatic conditions. Usually the toes and fingers are the primary parts that are affected; however in certain instances, the lips, nipples or nose may also get affected. The attacks are short lived but can occur frequently. The following are the various signs and symptoms of Raynaud’s disease.

• The affected area turns white, followed by blue and then red color.
• The area is painful to touch, is numb and also tender.
• As the blood flow gradually returns to normal, the area may throb or tingle and can even produce a burning sensation.
• The order of color changes as described here may not be the same for all individuals. 

• Splenomegaly

  Examine any joints that are sore, palpate the abdomen to exclude hepato/splenomegaly and check the lymph fields to detect any evidence of malignancy. [patient.info]

• Pain

  Results: Sixteen of 19 patients (84 percent) reported pain reduction at rest. Thirteen patients reported immediate relief; three reported more gradual pain reduction over 1 to 2 months. Three patients had no or minimal pain relief. [doi.org]

  Dysesthesiae and regional diaphoresis may coincide with the ischemic phase, while throbbing pain often accompanies recovery. Trophic changes of sclerodactyly and, rarely, fingertip ulcerations or gangrene, [jamanetwork.com]

  This may be accompanied by pain, or more commonly by numbness. In severe cases there may damage to the skin on the tips of the toes and fingers with an appearance similar to frostbite. [podiatrynetwork.com]

• Gangrene

  Trophic changes of sclerodactyly and, rarely, fingertip ulcerations or gangrene, [jamanetwork.com]

  gangrene Raynauds syndrome Raynauds syndrome w gangrene Raynauds syndrome with gangrene Secondary Raynaud phenomenon with gangrene Secondary Raynaud's phenomenon Clinical Information A set of symptoms characteristic of peripheral vascular disease, namely [icd9data.com]

  Whereas Raynaud’s disease is benign and often controllable, Raynaud’s phenomenon may progress to atrophy of the terminal fat pads and development of fingertip gangrene. [health.am]

  Severe secondary Raynaud's can cause skin sores or gangrene. "Gangrene" refers to the death or decay of body tissues. Fortunately, severe Raynaud's is rare. [web.archive.org]

  Severe cases may lead to digital infarction and gangrene with loss of the tissue of the finger pulp or distal phalanx. [patient.info]

• Raynaud Syndrome

  Primary Raynaud syndrome is much more common then secondary Raynaud syndrome. Between 60% and 90% of cases of primary Raynaud syndrome occur in women aged 15 to 40. [msdmanuals.com]

  Raynaud’s phenomenon is also occasionally seen in patients with neurogenic thoracic outlet syndrome or carpal tunnel syndrome. [health.am]

  From Wikidata Jump to navigation Jump to search medical condition in which spasm of arteries cause episodes of reduced blood flow Raynaud's syndrome Raynauds phenomenon Raynaud's phenomenon Raynaud's disease edit English Raynaud syndrome medical condition [wikidata.org]

• Swelling

  Swelling may occur, along with skin discoloration, numbness, and a tingling feeling. The course of the disease is variable and unpredictable. Sometimes years… Read More [britannica.com]

  It then sends disease-fighting antibodies to the tissue which can cause a range of symptoms, such as redness and swelling in the affected area. [hse.ie]

  When the blood supply returns on warming the extremities turn red with tingling and swelling. Prevention: People suffering from Raynaud's disease should keep their extremities warm by wearing gloves and socks. [askdrshah.com]

  Once the area is warmed and blood flow returns, a tingling sensation may accompany a red flush and, possibly, swelling. There may also be a painful, throbbing sensation. [splitrockrehab.com]

  As circulation returns, they may turn red and throb, tingle, or swell. A Raynaud’s attack may last anywhere from seconds to hours. [disabilitysecrets.com]

• Severe Pain

  Often, along with the color change will be discomfort or even severe pain. [hss.edu]

  In patients with severe pain or complications such as digital vessel thrombosis (clotting), or ulceration of the skin; medical treatment with vasodilatation agents should also be considered. [evergreenhealth.com]

  For some, severe pain from Raynaud's causes them to lose concentration; if this is true for you, the claims examiner should consider whether this could interfere with your ability to do many types of sedentary work. [disabilitysecrets.com]

• Cyanosis

  The typical acute attack comprises sequential phases of digital pallor, cyanosis, and rubor induced by cold or emotive stimuli. [jamanetwork.com]

  Introduction Essentials of Diagnosis Episodic bilateral digital pallor, cyanosis, and rubor. Precipitated by cold or emotional stress; relieved by warmth. Seventy to 80 percent of patients are women. [health.am]

  Cyanosis (blueness) appears because the fingers or toes are not getting enough oxygen-rich blood. Other symptoms that occur during cyanosis are feeling cold and numbness. Rubor (redness) occurs as the blood returns to the affected areas. [my.clevelandclinic.org]

  Ray·naud's disease | \ rā-ˈnōz- \ Medical Definition of Raynaud's disease : a vascular disorder that is marked by recurrent spasm of the capillaries and especially those of the fingers and toes upon exposure to cold, that is characterized by pallor, cyanosis [merriam-webster.com]

  Cold fingers or toes with color changes of skin in response to cold or stress Pallor/blanching, typically of the fingers or toes with triphasic color changes in the fingers, consisting of pallor, cyanosis, and rubor Paresthesias (numbness), prickly feeling [handsurgeryresource.com]

• Vascular Disease

  In patients with tissue loss or gangrene, performing an angiogram may be helpful in identifying other types of peripheral vascular disease and the extent of the vascular compromise. [evergreenhealth.com]

  The patients developed cold intolerance secondary to atherosclerosis or collagen vascular disease. The results were analyzed using the criteria of ulcer healing and the prevention of amputation. [ncbi.nlm.nih.gov]

  (eds.): peripheral vascular diseases, pp. 555-83. Philadelphia: w.b. Saunders co., 1980. 2) porter, jm; snider, rl; bardana, ej; rosch, j and eidemiller, lr: the diagnosis and treatment of raynaud's phenomenon. Surgery 77:11, 1975. [icd9data.com]

• Acrocyanosis

  Acrocyanosis affects both men and women, and the age at onset is usually between 20 and 45 years. The prognosis of patients with idiopathic acrocyanosis is good, and loss of digital tissue is uncommon. [hyperhidrosis-usa.com]

  To help differentiate benign acrocyanosis from acrocyanosis associated with other serious conditions, the differential diagnosis of unilateral and bilateral acrocyanosis in infants is also discussed. [ped-rheum.biomedcentral.com]

  Other vasospastic disorders that should be included in the differential but are usually easily distinguishable by physical examination are acrocyanosis and livedo reticularis. Treatment A. [health.am]

  See also acrocyanosis. This article was most recently revised and updated by Amy Tikkanen, Corrections Manager. [britannica.com]

  Acrocyanosis also causes color change of the digits in response to cold but differs from Raynaud syndrome in that it is persistent, not easily reversed, and does not cause trophic changes, ulcers, or pain. [merckmanuals.com]

• Heart Failure

  People with myocardial infarction, aortic stenosis, heart failure, peripheral oedema, symptomatic low blood pressure, and unstable angina. A lower dose may be required in the elderly and in people with severe liver disease. [patient.info]

• Foot Pain

  Foot Pain Foot pain can sometimes be a sign of an underlying condition that requires medical attention. Find out when to see your doctor, and much more. Orthotics Many people use orthotics to improve the function and stability of their feet. [footvitals.com]

  Ball-of-foot pain is one of the most common symptoms associated with hammertoes. [nwfootankle.com]

• Flushing

  Fingers or toes turn from white to blue and, then, as the blood returns, they flush red. [splitrockrehab.com]

  Once the area is warmed and blood flow returns, a tingling sensation may accompany a red flush and, possibly, swelling. There may also be a painful, throbbing sensation. [medicalnewstoday.com]

• Erythema

  They may be triphasic (pallor, followed by cyanosis and after warming by erythema due to reactive hyperemia), biphasic (cyanosis, erythema), or uniphasic (pallor or cyanosis only). Changes are often symmetric. [merckmanuals.com]

  It is characterised by vasospasm of the arterioles causing intermittent ischaemia, which is manifested as pallor, followed by cyanosis as the venous blood is deoxygenated, and then erythema when reflex vasodilatation occurs. [doi.org]

  Finally, with recovery, there is increased blood flow with resulting erythema of the fingers. With observation of two of the three color changes, raynaud's phenomenon is considered present. [icd9data.com]

  When reflex vasodilatation occurs, there is subsequent erythema of the affected body part. This triphasic color change is usually associated with pain, burning, and paresthesias. [pediatrics.aappublications.org]

  […] mechanisms and of intravascular circulating factors are known to interact and contribute. [ 1 ] Note that Raynaud also has a type of gangrene (symmetrical gangrene of the extremities) and a sign (symmetrical, mottled cyanosis of extremities with patches of erythema [patient.info]

• Fingertip Ulceration

  Trophic changes of sclerodactyly and, rarely, fingertip ulcerations or gangrene, [jamanetwork.com]

  People with secondary Raynaud's phenomenon are at risk for fingertip ulcers and tend to have active symptoms all year long. [orthop.washington.edu]

  Care of the nails must be done carefully to avoid injuring sensitive toes and fingertips. Ulcers on the tips of the digits should be monitored closely by the doctor. These can become infected. [medicinenet.com]

• Paresthesia

  During the trial all patients were subjected to finger photoplethysmography and were given a diary to note daily the number and duration of the crises and presence or absence of pain and paresthesia. [ncbi.nlm.nih.gov]

  Cold fingers or toes with color changes of skin in response to cold or stress Pallor/blanching, typically of the fingers or toes with triphasic color changes in the fingers, consisting of pallor, cyanosis, and rubor Paresthesias (numbness), prickly feeling [handsurgeryresource.com]

  Mild discomfort, paresthesias, numbness, and trace edema often accompany the color changes. [health.am]

  […] pain, pallor, and prickling; phenomenon applies to secondary symptoms, disease when cause is unknown Intermittent bilateral attacks of ischemia of the fingers or toes and sometimes of the ears or nose, marked by severe pallor, and often accompanied by paresthesia [icd9data.com]

• Dysesthesia

  Dysesthesiae and regional diaphoresis may coincide with the ischemic phase, while throbbing pain often accompanies recovery. Trophic changes of sclerodactyly and, rarely, fingertip ulcerations or gangrene, [jamanetwork.com]

A preliminary history of the disease will be taken followed by a physical examination of the affected areas. In addition, various other laboratory tests and imaging studies would also be carried out to diagnose the condition [7]. These include:

• Blood tests to determine complete blood count, urea nitrogen, prothrombin time, serum glucose and thyroid stimulating hormones are carried out.
• Antinuclear antibody test is done to analyze for the presence of antinuclear antibodies. If the test turns out to be positive it indicates a stimulated immune system which is another marker for Raynaud’s disease.
• Erythrocyte sedimentation rate is necessary to distinguish Raynaud’s disease from secondary Raynaud’s phenomenon. A faster than normal sedimentation rate indicates that there is an underlying disease condition.

• Thrombocytosis

  Secondary erythromelalgia can result from small fiber peripheral neuropathy of any cause, polycythemia vera, essential thrombocytosis,[1] hypercholesterolemia, mushroom or mercury poisoning, and some autoimmune disorders. [en.wikipedia.org]

Raynaud’s disease can be treated by adopting simple lifestyle changes. In addition, medications are also employed to reduce the symptoms and prevent future attacks. The following are the various methods for treating Raynaud’s disease:

• Adopting lifestyle changes: Simple steps such as wearing gloves while handling cold substances or in cold climate can help prevent attacks of vasopasm.
• Medications: Medications such as calcium channel blockers, alpha blockers and vasodialtors are prescribed for severe cases. In majority of the cases, nifedipine is the usual choice. In many instances, topical nitroglycerin to be applied locally on the affected areas has also been found to be helpful [8].
• Non-pharmacologic approach: In such type of therapy, patients are advised to avoid foods or conditions that can trigger or generate attacks of Raynaud’s disease. These include avoiding smoking, drugs that can instigate an attack of vasospasm and wearing of appropriate warm clothing in cold climate or while handling frozen stuff [9].
• Diet: There is small evidence suggesting the use of omega-3 fatty acids contained in fish oils to have positive effect on symptoms. Studies have shown a positive association between consumption of fish oils and improvement in the symptoms of Raynaud’s disease [10].

In majority of the cases, prognosis of Raynaud’s disease is extremely favorable. So far no cases of mortality associated with this disease condition has been noted. However, there have been certain pieces of evidences suggesting that if ischemia of the affected body develops then it can lead to necrosis [6].

The exact factors that lead to development of Raynaud’s disease are unknown. However, extreme cold temperatures or stressful conditions can predispose an individual to develop such a condition [3]. Exposure to extreme cold climates or inserting hands in cold water can trigger an attack of Raynaud’s disease. Women are more prone to develop such a condition and those with a family history of this disease are also at an increased risk.

In the United States, it has been estimated that about 2.2% of women and 1.5% of men per year develop Raynaud’s disease [4]. Globally the rate of prevalence of Raynaud’s disease varies from 4.9% to 20.1% in women, to about 3.8% to 13.5% amongst the men population. The disease usually shows signs of development in individuals aged 20 to 30 years.

In extreme cold temperatures or in conditions of stress, the body parts such as fingers and toes may develop a condition known as vasospasm. This is a condition characterized by narrowing of the arteries that limits blood supply to the affected area.

The condition often develops in 3 distinct stages defined as vasoconstriction (initial white coloration), accompanied by cyanosis (development of blue color) and finally rapid blood flow that causes development of red color. The parts that are most exposed to extreme cold temperatures such as the toes and fingers develop this condition [5].

Individuals prone to develop Raynaud’s disease should consider the following to prevent attacks of the disease:

• Appropriate clothing: Individuals should appropriately dress up during winters. They should also wear warm covering while handling frozen food stuff. While stepping out, it is necessary to wear an extra layer of warmers to negate the effect of cold climate.
• Relocation: Individuals with severe Raynaud’s disease should consider relocating to warmer climates to prevent attacks of the disease.

Raynaud’s disease is a rare condition characterized by narrowing of the arteries that carry blood from the heart to different parts of the body. Such a process limits blood circulation to the affected areas [1]. Occurrence of short episodes of vasopasm defined as narrowing of blood vessels mark the development of Raynaud’s disease.

Raynaud’s is basically divided into 2 categories, namely primary and secondary phenomenon. Both these conditions share the same name but have distinct features. The primary Raynaud’s phenomenon is also known as the Raynaud’s disease. This disease was named after the medical student Maurice Raynaud who first defined the characteristics of this condition [2].

Definition

Raynaud’s disease is characterized by attacks of vasospasm that mainly affects the toes and fingers. These are the parts usually exposed to cold climate or extreme conditions. In this condition, the blood supply to the affected area is restricted causing development of vasoconstriction, cyanosis and rapid blood flow. The condition is more common in women than men.

Cause

The exact cause of Raynaud’s disease is unknown. Extreme cold temperatures and conditions of stress are known to induce attacks of vasospasm. The exposed areas of the body, most commonly the toes and fingers are known to get affected.

Symptoms

Symptoms of Raynaud’s disease include color changes of the affected areas. Toes and fingers may first turn white color which may then turn blue. Numbness can also set in.

Diagnosis

Diagnosis consists of blood tests to rule out underlying disease conditions. In addition, antinuclear antibody test is also done to assess the levels of the antibody.

Treatment

Treatment of Raynaud’s disease includes making certain lifestyle changes to manage the symptoms and prevent future attacks. In addition, certain medications are also given such as calcium channel blockers to relieve the symptoms. In many cases, topical application of nitroglycerin is also advised.

1. Block JA, Sequeira W. Raynaud's phenomenon. Lancet 2001; 357:2042.
2. LeRoy EC, Medsger TA Jr. Raynaud's phenomenon: a proposal for classification. ClinExpRheumatol 1992; 10:485.
3. Coulombe J, Powell J, Hatami A, McCuaig C, Renet S, Marcoux D. Diseases of abnormal sensitivity to cold in children on psychostimulant drugs. J Cutan Med Surg. Oct 2014;18(5):1-4.
4. Suter LG, Murabito JM, Felson DT, Fraenkel L. The incidence and natural history of Raynaud's phenomenon in the community. Arthritis Rheum. Apr 2005;52(4):1259-63.
5. Wigley FM, Flavahan NA. Raynaud's phenomenon. Rheum Dis Clin North Am. Nov 1996;22(4):765-81.
6. Wigley FM. Clinical practice. Raynaud's Phenomenon. N Engl J Med 2002; 347:1001.
7. Lavery JP, Lisse JR. Raynaud's Phenomenon. In: Taylor RB, ed. Difficult Diagnosis. Vol 2. Philadelphia, Pa: WB Saunders Co; 1992:386-91.
8. Ennis H, Anderson ME, Wilkinson J, Herrick AL. Calcium channel blockers for primary Raynaud's phenomenon. Cochrane Database Syst Rev. Jan 30 2014;1:CD002069.
9. Malenfant D, Catton M, Pope JE. The efficacy of complementary and alternative medicine in the treatment of Raynaud's phenomenon: a literature review and meta-analysis. Rheumatology (Oxford). Jul 2009;48(7):791-5.
10. DiGiacomo RA, Kremer JM, Shah DM. Fish-oil dietary supplementation in patients with Raynaud's phenomenon: a double-blind, controlled, prospective study. Am J Med. Feb 1989;86(2):158-64.