Tips from Patients
|What is Raynaud's?
Photos of Attacks
Disease vs. Phenomenon
With Other Diseases
Raynaud's of the Nipples
|Raynaud's of the Lungs
Doubles Risk of Heart Problems
Importance of Controlling
Other Ways Scleroderma Can Affect Hands
Raynaud's in Children
Raynaud's is a vascular disorder commonly found in sclerodema. It is an extreme spasm of blood vessels in response to cold or stress.
How do you pronounce "Raynaud's"? Raynard, Raynod, Raynoze, RAYnadds, Raynaws, Raynowds, RAYnoz, Rayners, RP, or Raywhatsit? ISN's Sclero Forums discussion.
Raynaud Phenomenon. Raynaud phenomenon manifests as recurrent vasospasm of the fingers and toes and usually occurs in response to stress or cold exposure. Medscape.
All of these pictures of Raynaud's are from our ISN Photo Repository of Scleroderma Symptoms.
Blue phases indicate that at least some blood is getting through, which means blue is better than white when it comes to Raynaud's. However, blue episodes or phases are much more dramatic, attention-getting, and photogenic.
Also, an isolated or very occasional color change due to prolonged or significant cold exposure or consumption of vasco-constrictors (caffeine or nicotine, for example) is possible for even an entirely healthy person. In those cases, it would be wise to wear gloves, keep warm, avoid triggers, and see your doctor if it continues or worsens, or if you develop other symptoms as well.
In between attacks of Raynaud's, the affected areas appear normal.
Sometimes when the circulation returns (which is called "reperfusion") the skin will turn bright pink or red (which is a good thing.)
Because perfusion (and reperfusion) is a good thing, it is only the phase of turning white or blue (or both) that meets the diagnostic criteria for Raynaud's.
ISN Photo Repository: Raynaud's (Judith T.) ISN.
Raynaud's occurs in 3 to 5% of the general population; however, more than 80% of patients with Raynaud's do not have a connective tissue disease or other serious illness. Scleroderma: Symptoms and Complications. University of Maryland Medical Center.
When Raynaud's appears by itself, without any other medical condition, it is called Raynaud's Disease. 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 sometimes make medication ineffective. Digital (Finger) Ulcers are caused by the lack of oxygen to skin cells.
Just 5 to 20 percent of people with Raynaud's phenomenon subsequently develop scleroderma, but about 90 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. What Causes Raynaud's? National Heart Lung and Blood Institute. NIH.
Incidences and Risk Factors of Organ Manifestations in the Early Course of Systemic Sclerosis (SSc): A Longitudinal EUSTAR Study. In SSc patients presenting early after Raynaud's phenomenon onset, approximately half of all incident organ manifestations occur within 2 years and have a simultaneous rather than a sequential onset. PubMed, PLoS One, 2016 Oct 5;11(10):e0163894.
Systemic sclerosis without antinuclear antibodies (ANA) or Raynaud's phenomenon (RP): a multicentre study in the prospective EULAR Scleroderma Trials and Research (EUSTAR) database. Prospective studies are needed to elucidate the clinical presentation, evolution and outcome of such patients. PubMed, Rheumatology, 2013 Mar;52(3):560-7. (Also see What is Scleroderma? and Antibodies in Systemic Scleroderma)
Thumb Involvement in Raynaud's Phenomenon as an Indicator of Underlying Connective Tissue Disease. Thumb involvement is one of a number of clinical indicators that should alert the clinician to the possibility of an underlying connective tissue disease/disorder. JRheum. March 1, 2010.
Vascular Disease and Systemic Scleroderma. Any condition that affects the vascular system, all of in part, is considered a vascular disease. ISN.
Vascular in Scleroderma
Types in Scleroderma
In Other CTDs
The association of antiphospholipid antibodies (APLA) with cardiopulmonary manifestations of systemic sclerosis. APLA is associated with pulmonary arterial hypertension (PH), interstitial lung disease, Raynaud's phenomenon and digital ulcers, so endothelial abnormalities and small vessel thrombosis may be important in the pathogenesis of these disease features. PubMed, Clin Exp Rheumatol, 2014 Feb 24. (Also see Antiphospholipid Syndrome, Causes of Pulmonary Hypertension , and Digital Ulcers)
Raynaud's Phenomenon of the Nipple Associated with Labetalol Use. Precipitants for Raynaud's phenomenon of the nipple are known to be cold temperatures, caffeine, and emotional stress. J Hum Lact, February 2013 vol. 29 no. 1 17-19.
Raynaud's may also affect the tip of the nose, earlobes, cheeks, chin, or lungs. Some people with scleroderma and Raynaud's experience coughing attacks when breathing cold air or drinking/eating cold liquids and foods. The coughing may or may not be caused by pulmonary vasospasms caused by exposure to cold.
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
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.
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. (Also see Scleroderma Skin Involvement, Skeletal Involvement, Telangiectasia, and Calcinosis)
Pediatric Raynaud Phenomenon. The overall prevalence of Raynaud's in 12-15 year olds was 14.9%. Medscape.
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