About Raynaud’s Phenomenon
Raynaud’s phenomenon is defined as vascular spasms in extremities leading to triphasic color changes: white (due to ischemia), blue (due to cyanosis), then red (due to reperfusion). Fingers and toes are most commonly affected; however, sometimes other areas are involved (tip of nose, lips, earlobes).
Raynaud’s is classified into two different types:
- Primary Raynaud’s: occurs on its own without connection to another disease or condition.
- Secondary Raynaud’s: occurs as a symptom associated with an underlying condition, medication, or lifestyle factor.
Triphasic color changes of Raynaud's may be missed in patients with darker skin tones
Shows marked pallor of the 4th and 5th digits on the left hand and of the 5th digit on the right hand
Well-demarcated pallor present in the fingers of both hands
Shows cyanotic changes in the fingers
Shows the blanching phase of Raynaud's phenomenon
Digital ulcerations in long-standing Raynaud's
- Vasculopathy:
- Occlusive peripheral vascular disease
- Livedo reticularis
- Chilblains
- Thromboangiitis obliterans
- Thromboembolic disease
- Acute idiopathic blue finger (paroxysmal finger hematoma)
- Acrocyanosis
- External blood vessel compression
- Complex regional pain syndrome
- Erythromelalgia
- Peripheral neuropathy
- Excessive cold sensitivity
- Smoking
- Caffeine
- Emotional stress
- Drugs: Migraine medications (serotonin agonist), sympathomimetics, beta-blockers, ADHD medications, chemotherapeutics, others (interferons, cocaine, polyvinyl chloride)
- Systemic sclerosis
- Systemic lupus erythematosus
- Myositis
- Mixed connective tissue disease
- Sjogren’s disease
- Cryoglobulinemia
- Vasculitis
- Cold agglutinin disease
- Paraneoplastic syndrome