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. 2021 Apr 9;118(Forthcoming):273-280.
doi: 10.3238/arztebl.m2021.0023. Online ahead of print.

Raynaud's Phenomenon: A Vascular Acrosyndrome That Requires Long-Term Care

Peter Klein-Weigel, Oliver Sander, Simone Reinhold, Jessica Nielitz, Julia Steindl, Jutta Richter

Raynaud's Phenomenon: A Vascular Acrosyndrome That Requires Long-Term Care

Peter Klein-Weigel et al. Dtsch Arztebl Int. .

Abstract

Background: Some 5-10% of the German population are affected by Raynaud's phenomenon (RP). In around 10-20% of cases RP arises from an underlying disease, most commonly a connective tissue disease. This review encompasses the diagnosis and differential diagnosis of RP and examines the efficacy of the currently available pharmaceutical and non-pharmaceutical treatment options.

Methods: We conducted a selective literature search in PubMed using the search terms "Raynaud's phenomenon", "Raynaud's syndrome," "vasospasm," "vascular acrosyndrome," and "systemic sclerosis," together with a search of the Cochrane Database of Systematic Reviews up to April 2020.

Results: Raynaud's phenomenon mainly affects the fingers or toes and is typically triggered by cold or emotional stressors. The most important diagnostic steps are demonstration of a tendency towards digital vasospasm, exclusion of occlusions in the afferent arteries and acral vessels, nail-fold capillaroscopy, and determination of autoantibody status. Tumor screening should be arranged in the presence of B symptoms or first manifestation of RP in old age. The onset of RP in childhood is a rare occurrence and points to a secondary origin. The principal options for treatment are protection against cold and administration of calcium antagonists, which reduces the occurrence of RP by around 20-40 %. The treatment of RP in patients with systemic sclerosis is described in the recommendations of the European League Against Rheumatism (EULAR).

Conclusion: At onset or after years of latency, patients with Raynaud phenomenon may have an underlying disease (most commonly a connective tissue disease). Long-term specialist care is necessary for asymptomatic patients with risk factors and for those with clinically manifest symptoms of an underlying condition alike.

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Figures

Figure 1 (a, b)
Figure 1 (a, b)
Typical “white phase” of Raynaud’s phenomenon in the fingers
Figure 2 (a, b)
Figure 2 (a, b)
Systemic sclerosis with permanent digital ischemia in hand/digital artery occlusion and early flexion contracture of the fingers
Figure 3
Figure 3
Example of normal findings in nailfold capillaroscopy showing normal capillary density and normal capillary morphology
Figure 4
Figure 4
Nailfold capillary morphological findings in systemic sclerosis
See this image and copyright information in PMC

Comment in

  • Incomplete Description.
    Lieber A, Scheuermann-Poley C. Lieber A, et al. Dtsch Arztebl Int. 2021 Sep 6;118I processed the file.I'm waiting for feedback tomorrow(35-36):604. doi: 10.3238/arztebl.m2021.0281. Dtsch Arztebl Int. 2021. PMID: 34789377 Free PMC article. No abstract available.
  • Percutaneous Thoracic Sympathicolysis.
    Özgün M, Beyer F. Özgün M, et al. Dtsch Arztebl Int. 2021 Sep 6;118I processed the file.I'm waiting for feedback tomorrow(35-36):604. doi: 10.3238/arztebl.m2021.0283. Dtsch Arztebl Int. 2021. PMID: 34789378 Free PMC article. No abstract available.
  • Raynaud's Phenomenon in the Breast Nipple Area.
    Koschinski-Möller B. Koschinski-Möller B. Dtsch Arztebl Int. 2021 Sep 6;118I processed the file.I'm waiting for feedback tomorrow(35-36):605. doi: 10.3238/arztebl.m2021.0282. Dtsch Arztebl Int. 2021. PMID: 34789379 Free PMC article. No abstract available.

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