Raynaud syndrome
Overview
- Primary (idiopathic) Raynaud's phenomenon: Onset typically in young women before the age of 30; symmetric involvement of both hands, triggered by cold and stress (smoking aggravates the attacks), no trophic lesions, ANA negative, normal ESR and a normal nailfold capillaroscopy.
- Secondary Raynaud's phenomenon: A symptom of an underlying disease — connective tissue diseases (systemic sclerosis, MCTD, SLE, dermatomyositis, Sjögren's syndrome), vasculitides, cryoglobulinaemia, drugs (beta blockers, ergotamines, bleomycin), vibration injury ("vibration white finger") and thoracic outlet syndrome. Red flags are later onset, asymmetric involvement, digital ulcers and necroses together with positive ANA plus specific antibodies (anti-centromere, anti-Scl-70, anti-RNA polymerase III).
- Workup: History (occupation/vibration, drugs, smoking), then the two investigations that separate primary from secondary disease: nailfold capillary microscopy (megacapillaries, capillary loss, avascular areas) and ANA/ENA testing. If abnormal, search for organ involvement (lung function with DLCO, echocardiography, oesophageal studies).
Differential diagnoses
- Pernio (Chilblain)
- Chilblains
- Erythromelalgia
- Livedo reticularis
- Cholesterol embolism
- Systemic sclerosis
- Antiphospholipid Syndrome
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Note: This page is intended for medical education and does not replace diagnosis or treatment decisions in individual cases. Treatment and follow-up content is available in the app.