Raynaud's disease (Raynaud's phenomenon)

Raynaud’s disease, or Raynaud’s phenomenon, is a form of vasculitis in which the arteries of the fingers or toes suddenly narrow in response to cold, causing a tri-phasic reaction in which the digits turn white, blue and then red. Even mild cold exposure can cause this painful reaction.

Raynaud’s disease refers to vasospasm — severe, temporary narrowing of the arteries that occurs in response to cold or stress in the absence of any other medical condition. Raynaud’s phenomenon is used to describe those cases associated with other disease, such as scleroderma or systemic lupus erythematosus, that occur in response to cold.

As many as five percent of the United States population has Raynaud’s disease or Raynaud’s phenomenon, 80 percent of those with the condition are women.

Both Raynaud’s disease and Raynaud’s phenomenon are characterized by tri-phasic reaction in which the fingers or toes turn white, blue and then red. This reaction, which is caused by the sudden constriction of blood vessels, can result in numbness. Sometimes, the reaction can also affect the nose or ears. Severe cases may include ulcerations of the finger pads or the development of gangrene.

The cause of Raynaud’s disease is unknown. The risk factors for developing the disorder include:

• Existing connective tissue or autoimmune disease
• Cigarette smoking
• Alcohol use
• Helicobacter pylori infection, a bacterium found in the stomach that causes inflammation and ulcers

The diseases most frequently associated with Raynaud’s phenomenon include:

• Systemic lupus erythematosus (lupus)
• Scleroderma
• Buerger’s disease
• Sjögren’s syndrome
• Rheumatoid arthritis
• Occlusive vascular disease
• Polymyositis
• Cryoglobulinemia
• CREST syndrome (Calcium skin deposits, Raynaud’s phenomenon, Esophageal dysmotility, Sclerodactyly and Telangiectasis)

The diagnosis of Raynaud’s disease or Raynaud’s phenomenon is made by a physician who evaluates the patient, including testing for underlying diseases or injuries that may be causing the reaction.

There is no cure for Raynaud’s disease or Raynaud’s phenomenon. However, several steps can be taken to decrease the severity and frequency of the attacks. These include:

• Smoking cessation
• Avoid sudden changes in temperature, such as going from warm air to air conditioning
• Wear a coat, mittens and hat in cold weather (gloves allow cold air to surround fingers)
• Avoid trauma or vibration to the hands
• Avoid excessive stress

Medication that relaxes the arteries may also be prescribed, especially during winter months. Sores that appear on the fingers or toes require medical attention.