| RAYNAUD'S:
MAIN MENU |
|
| What
is Raynaud's? |
| This
page was written by Shelley
Ensz, and has not yet been medically edited. Scleroderma
(SD) affects everyone differently. Just because something
is listed here does not mean an individual patient will ever
experience it. See Disclaimer. |
|
| What is Raynaud's? |
 Raynaud's
is an extreme spasm of blood vessels in response to cold
or stress. The fingers and/or toes become white and/or blue,
and may become red on re-warming.
Photo: Severe
attack of Raynaud's in a systemic scleroderma patient with
both blue and white fingers (and also calcinosis on
one finger). |
| How do you pronounce "Raynaud's"? Raynard, Raynod, Raynoze, RAYnadds, Raynaws, Raynowds, RAYnoz, Rayners, or Raywhatsit? ISN's Sclero Forums discussion. |
| Raynaud's
Disease and Phenomenon. Merck Manual. |
| Raynaud
Phenomenon. eMedicine Journal. |
| Raynaud's Disease and Phenomenon. (CNN.com) Mayo Clinic. |
| Blunted increase of digital skin vasomotion following acetylcholine and sodium nitroprusside iontophoresis in systemic sclerosis (SSc) patients. This study showed a selective abnormality of the endothelial, sympathetic and myogenic-dependent finger skin vasomotion in SSc patients, consistent with a parallel endothelial, sympathetic and myogenic macrovascular dysfunction. M. Rossi. Rheumatology. April 22, 2008. (Vasomotion is cyclic variation in vascular diameter) (Also see: Digital Ulcers) |
| Maximum blood flow and microvascular regulatory responses
in systemic sclerosis. SSc patients have abnormal microvascular regulatory
responses compared with PRP and controls. This study also suggests that the
degree of endothelial dysfunction may be related to the degree of peripheral
vascular involvement. Rheumatology 2007 46(7):1079-1082. |
| Capillaroscopic
patterns in rheumatic diseases. Microvascular damage is a typical
feature of Systemic Sclerosis (SSc) and more than 95% of the patients
present architectural disorganization, giant capillaries, haemorrhages,
loss of capillaries, avascular areas and neovascularization, as
main microvascular abnormalities. These sequential capillaroscopic
changes characterize the "scleroderma pattern" and reflect the
SSc microangiopathy. PubMed. Acta Reumatol Port. 2007 Jan-Mar;32(1):29-36.
(Also see: Common Medical Tests) |
| Raynaud’s Disease:
the Reason Behind Cold, White Fingers and Toes. Exposure to cold normally
results in slowing of blood flow to fingers and toes. Small arteries in
extremities narrow, reducing blood flow and preserving the core body temperature.
For people with Raynaud’s disease, the response is exaggerated for unknown
reasons. Newswise. Mayo Clinic Health Letter. 05/09/07. |
| Feeling
the chill: Raynaud's phenomenon sufferers battle cold hands, feet - and
misconceptions. The New York-based Raynaud's Association, an international
support group of about 2,500 patients, estimates that 5 percent to 10 percent
of Americans experience the phenomenon, though many may not know they have
it. The Eagle-Tribune. 04/23/07. |
| Raynaud's
phenomenon in dermatology: Part 1: Pathophysiology and diagnostic
approach. Raynaud phenomenon is characterized by recurrent
spasms of small digital arterioles/arteries at fingers and
toes, usually triggered by cold and emotional stress. PubMed.
Hautarzt. 2006 Sep;57(9):819-830. |
| Raynaud's
phenomenon in dermatology: Part 2: Therapy. While primary
Raynaud's phenomenon (RP) only rarely leads to complications,
secondary RP when associated with systemic sclerosis frequently
results in necrosis, ulcers or even gangrene. Therefore timely
therapeutic intervention is required. PubMed. Hautarzt.
2006 Oct;57(10):927-942. (Also see: Raynaud's
Treatments) |
| Raynaud’s awareness. This common and debilitating condition affects the blood supply to the body's extremities and when an attack strikes, sufferers experience numbness and pain as their feet and hands become white and dead-looking. As the blood returns, the extremities in turn become bright red, with further pain and loss of feeling. SUR in English. 02/09/07. |
| Raynaud's
phenomenon. Raynaud's phenomenon (RP) is a vasospastic
disorder characterized by episodic color changes of blanching,
cyanosis, and hyperemia in response to cold and/or emotional
stress. Secondary RP is characterized by an age of onset
of more than 30 years, painful and asymmetric attacks, ischemic
skin lesions, positive autoantibodies, capillaroscopic abnormalities
and/or clinical features suggestive of connective tissue
diseases (CTDs). Among the CTDs, systemic sclerosis has the
highest frequency of RP. PubMed. Reumatismo. 2004 Apr-Jun;56(2):77-81. |
| Photos of Raynaud's Attacks |
| Most Raynaud's attacks are not this visible. Usually attacks cause the skin to go dead white. However, atttacks that incur blue fingers are much more dramatic and photogenic. In between attacks, the hands look normal. |
 ISN Photo Repository: Raynaud's (Alexandra M.) ISN. |
 ISN
Photo Repository: Raynauds (Joyce) ISN. |
 ISN
Photo Repository: Raynauds (Judith). ISN. |
 ISN Photo Repository: Raynaud's (Shelly S). ISN. |
| Gangrene and Amputations. ISN. |
| ISN Photo Repository: Finger Ulcers. ISN. |
| ISN
Photo Repository (Main Page). ISN. |
| Raynaud's Disease
vs. Raynaud's Phenomenon (or, Secondary Raynaud's) |
| When Raynaud's appears by itself,
without any other medical condition, it is called Raynaud's
Disease. About 1 in 20 adults have primary Raynaud's, whereas
only one in 4,000 have Scleroderma. When it appears along with
autoimmune diseases such as Scleroderma, Systemic Lupus Erythematosus,
and Rheumatoid Arthritis, it is called Raynaud's Phenomenon
(or, Secondary Raynaud's.) |
| In primary Raynaud's, the blood
vessels return to normal afterwards. However, in Raynaud's
with Scleroderma there may be blood vessel scarring which can
make medication ineffective. Digital
(Finger) Ulcers are caused by the lack of oxygen to skin
cells. |
| Transition From Primary To Secondary Raynaud’s Phenomenon (PRP / SRP): Identification By Nailfold Videocapillaroscopy During The Follow-Up. We showed the progression from PRP to SRP in 14.6% of the analyzed patients. We suggest the capillaroscopic analysis twice a year in presence of PRP, in order to early detect the transition to SRP in patients showing at the beginning a normal pattern or not-specific nailfold capillary abnormalities, as assessed by NC. A. Sulli OP0138 EULAR 2007. (Also see: Nailfold Capillaroscopy) |
| Transition
from primary Raynaud's (RP) phenomenon to secondary Raynaud's
phenomenon identified by diagnosis of an associated disease. Patients
diagnosed initially as having primary RP may actually comprise
1 of 3 groups: those with idiopathic RP, those with a rather
benign disease course, and those with a more severe course
of the disease. Arthritis & Rheumatism Journal. Vol
54, Issue 6:1974-1981 June 2006. |
| Raynaud's
phenomenon. Excluding Raynaud's of occupational origin,
the most common cause of secondary Raynaud's is a connective
tissue disease (particularly scleroderma). PubMed. Rev
Med Liege. 2004 Jun;59(6):378-84. (Also see: What
is Scleroderma?) |
| Raynaud's
phenomenon in undifferentiated connective tissue disease
(UCTD). Our study indicates that patients with UCTD would
seem to have a benign form of Raynaud's, since they show
the absence of cutaneous complications, the existence of
a mild microvascular damage and a stable nailfold capillary
pattern. PubMed. Clin Rheumatol. 2004 Sep 4. (Also see: Overlap/UCTD) |
| Raynaud's
phenomenon in children. It is important to distinguish
primary Raynaud's phenomenon, which is usually benign, from
Raynaud's phenomenon secondary to connective tissue disease. PubMed.
Arch Pediatr. 2004 Jan;11(1):74-7. (Also see Juvenile
Scleroderma) |
| Raynaud's and Scleroderma |
| Just 5 to 20 percent of people
with Raynaud's phenomenon subsequently develop scleroderma,
but nearly 90-95 percent of scleroderma patients experience
this extreme cold sensitivity with red/blue flashes in their
hands and feet as a primary manifestation of their disease. |
| In fact, Raynaud's is often the
first symptom of scleroderma, and may precede the onset of
Scleroderma by months or years. |
| Serum nitric oxide (NO)) metabolites and disease activity in patients with systemic sclerosis. Serum NO(x) in SSc patients were elevated compared to healthy controls. Serum NO(x) level was determined by multiple factors including age, prednisolone use, and elevated pulmonary arterial pressure. (PubMed) Clin Rheumatol. 2008 Mar;27(3):315-22. Epub 2007 Aug 15. (Also see: Nitric Oxide) |
| Hand vascular involvement assessed by magnetic resonance angiography in systemic sclerosis. Impairment of the microcirculation is a cardinal feature of systemic sclerosis (SSc). Magnetic resonance angiography (MRA) has improved the assessment of vascular lesions of the hand. The aim of this study was to evaluate vascular abnormalities in the hands of patients with SSc, using MRA. (Wiley InterScience) Arthritis & Rheumatism.Volume 56, Issue 8 , Pages 2747 - 2754. July 30 2007. (Also see: Digital Ulcers) |
| Therapeutic
management of acral manifestations of systemic sclerosis. Acral
manifestations of systemic sclerosis include Raynaud's phenomenon, calcinosis
cutis, and sclerodactyly. In the later stages of the disease, contractures
of the skin and joints as well as obliterative vasculopathy leading to
digital ulcers and necrotic lesions may occur. PubMed. Med Klin (Munich).
2007 Mar 15;102(3):209-18. (Also see: Calcinosis, Sclerodactyly, Digital Ulcers, and Skeletal Involvement: Joint Contractures) |
| Long Term Follow Up of a Cohort of Patients With Positive Antinuclear Antibodies (ANA) and Raynaud’s Phenomenon (RP) in the Absence of Connective Tissue Disease at Initial Evaluation. Initial evaluation indicates that there is a subset of patients who remain with only positive ANA and RP and do not develop a defined CTD. Marie S. O'Brien. 1881/553 ACR 2006. (Also see: Antibodies) |
| Pack
to aid 'blue hand' sufferers. Raynaud's Disease, a condition
of circulatory problems in which blood flow to the extremities
shuts down due to small changes in temperature could affect
up to one sixth of Halton's population and there are an estimated
10 million sufferers in the UK, almost twice the number of
asthmatics. icCheshireOnline. 08/24/06. (Also see: Scleroderma
Association UK) |
| Abnormal
microvascular response is localized to the digits in patients
with systemic sclerosis (SSc). This study suggests that
SSc has no effect on microvascular perfusion in the dorsum
of the hand, and that the abnormal microvascular response
is localized to the digits, affecting both smaller and larger
vessels. Arthritis & Rheumatism Journal. Vol 54, Issue
6:1952 - 1960 June 2006. (Also see: Digital
Ulcers) |
| Smokers
With Systemic Sclerosis Risk Severe Digital Vascular Complications. Patients
with systemic sclerosis (SSc) who smoke are three to four
times more likely than are never-smokers to incur digital
vascular complications, researchers in England have found. Doctor's
Guide. 1/24/03 Arthritis & Rheumatism 2002;46:12:3312-3316.
(Also see: Digital
Ulcers) |
| Raynaud's Phenomenon
of the Nipple |
| Thorough Patient History Can Pinpoint Raynaud of the Nipples. The pain from this vasospasm of the nipples while breast-feeding usually is bilateral, severe, and a spasm-like throb. The nipple usually turns very white but may be blue, purple, or red. Rheumatology News. Volume 6, Issue 9, Page 12 (Sept 2007) |
| Raynaud's
Phenomenon of the Nipple: A Treatable Cause of Painful Breastfeeding. Raynaud's
phenomenon has been reported to affect the nipples of breastfeeding
mothers and is recognized by many lactation experts as a
treatable cause of painful breastfeeding. Because the breast
pain associated with Raynaud's phenomenon is so severe and
throbbing, it is often mistaken for Candida albicans infection. PubMed.
Pediatrics. 2004 Apr;113(4):E360-4. |
| Raynaud's in the Lungs |
| Raynaud's may also affect the tip
of the nose, earlobes, cheeks, chin, or lungs. Breathing cold
air can cause a coughing attack if there is Raynaud's in the
lungs. The lungs are the internal organ most frequently affected
by Raynaud's. |
| Raynaud's phenomenon (RP) is correlated with elevated systolic pulmonary arterial pressure (PASP) in patients with systemic lupus erythematosus (SLE). In patients with SLE, the presence of RP was associated with elevation in PASP. Further investigation is needed to clarify the significance of this relation. Lupus (2007) 16, 505—508. (Also see: Lupus) |
| Doubles Risk of Coronary
Artery Disease and Stroke |
| A 1998 study indicated that people
who have Raynaud's may have double the risk of coronary artery
disease and stroke. "Hopkins: Is Raynaud's a Predictor
of Heart Disease?" by Fredrick M. Wigley, M.D., Professor
of Medicine and Director of Molecular and Clinical Rheumatology,
Johns Hopkins School of Medicine, August 19, 1998, Aetna InteliHealth. |
| Coronary
Artery Disease HeartPoint Gallery |
| Raynaud's
Phenomenon (RP), Systemic Sclerosis (SSc), and Macrovascular
Peripheral Disease. In this sample of atherosclerotic
patients, patients with RP were five times more prone to
coronary disease, compared to patients without RP, which
could suggest cardiac Raynaud's. SSc was more frequent than
expected. J. F. J. Olmedo. AB0284 EULAR 2006. (Also see: Cardiac
Involvement) |
| Importance of Controlling
Raynaud's |
| Scleroderma and Raynaud's can in
some instances become so severe as to require amputation of
fingers and/or toes, so keeping "aggressively warm" plus
promptly treating all Raynaud's attacks is essential for all
Scleroderma patients. As Raynaud's progresses, slight
drops in temperature may trigger it with longer duration of
the attacks. |
| Additionally, recent research indicates
that Raynaud's might be part of how the disease process advances
in Scleroderma, due to the oxygen deprivation caused by Raynaud's
spurring an abnormal chemical reaction which produces oxygen
radicals. Therefore, taking great precautions to prevent Raynaud's
attacks could be of paramount importance for Scleroderma patients. |
| Management of cutaneous vascular complications in systemic scleroderma: experience from the German network. Management of Raynaud's Phenomenon and ulcerations in SSc were heterogeneous at initiation of the network, reflecting a sometimes insufficient use of the diagnostic and therapeutic possibilities. (PubMed) Rheumatol Int. 2008 Mar 5. (Also see: Digital Ulcers) |
| Other Ways Scleroderma
Can Affect Hands |
| Raynaud's isn't the only way in
which Scleroderma can affect the hands. Hand involvement may
include skin tightening and hardening, finger contractures,
Telangiectasia, Calcinosis, and arthritis. See Skin
Involvement. |
| Raynaud's in Children |
| Raynaud's
phenomenon in children: a retrospective review of 123 patients. RP
in children, as in adults, principally affects girls and
is frequently free of association with connective tissue
disease. Antinuclear antibody positivity and abnormal nailfold
capillaries correlate with secondary disease. Antiphospholipid
antibodies are surprisingly common, a new finding of uncertain
implications. PubMed. Pediatrics 2003 Apr;111(4 Pt 1):715-21.
(Also see: Juvenile
Scleroderma) |
