Short duration vasospasms of the small arteries of the
arms and legs, hands and feet. Usually diagnosed before age 40 years.
Raynaud Disease; Raynaud Phenomenon; Acrocyanosis
Chronica Anesthetica; Symmetric Asphyxia.
Raynaud Disease refers to the familial (genetic) part. Raynaud Syndrome or Phenomenon refers to the acquired symptoms that are often associated with
Disorders associated with Raynaud Phenomenon include the following:
Neurovascular compression (thoracic outlet syndromes, crutch pressure
carpal tunnel syndrome)
Arterial diseases (thromboangiitis obliterans, thromboembolism,
Blood abnormalities (cryoglobulinemia, cryofibrinogenemia, cold
hemagglutinins, monoclonal gammopathy, polycythemia)
Occupational (percussion and vibratory tool workers, traumatic occlusive
arterial disease, vinyl chloride workers)
Drugs and toxins (ergot, methylsergide, beta-blocker drugs, chemotherapy,
Connective-tissue diseases (systemic sclerosis, systemic lupus
erythematosus, mixed connective-tissue disease, rheumatoid arthritis,
Miscellaneous (complex regional pain syndrome—reflex sympathetic
dystrophy, hypothyroidism, pheochromocytoma, neoplasm, primary pulmonary
hypertension, variant angina)
First described by A.G. Maurice Raynaud, French Physician,
Not known because of the confusion between the acquired form
and familial illness; however, reported to range from 0.06 to 30 from 0.006 to
30% in the general population. Primary disease may vary from 15 to 75%
in this population. Male:female ratio is 1:5. Most common in young women and 60 to 90%
of reported cases are idiopathic.
No evidence of genetic inheritance.
Clinically evocated by characteristic attack of distal
vasospasm with whitening of the extremities.
Intermittent attacks of numb and white fingers.
The classic description includes three phases. First, vasospasm leads to pallor of
the fingers and toes. Usually bilateral and involves all fingers.
Occasionally, it may involve ears and nose. Second, capillaries dilate after a few
minutes, but the digital arteries still are in spasm. The fingers get blue
and the numbness and pain appear. Finally, the vessels dilate with redness of the
fingers with a feeling of warmth and itching and tingling. In long-standing
cases, atrophy and resorption of the fingertips with or without painful
areas of necrosis may appear.
Assess the presence and the severity
of the underlying diseases.
Special attention to avoid cold
Avoid methylsergide and ergot
derivatives. Minimize the use of beta-blocking drugs, and, if possible,
catecholamines, especially the more potent alpha-vasoconstrictive ones. If
absolutely necessary, consider regional sympathetic blockade for the
CREST Syndrome: An autoimmune connective tissue
disorder associated with anticentromere antibodies. A form of scleroderma
associated with esophageal dysmotility.
Erythromelalgia: A disorder characterized by
vasodilatation associated with paroxysmal, intense burning pain, and
episodic reddening of the extremities (mainly feet). The symptoms of
redness, heat, pain, and swelling, when not associated with organic disease,
constitute the primary form, which has also been termed “erythermalgia”
because of the significance of the heat. The secondary or acquired ...