Reynauds

Reynauds, usually written Raynaud's phenomenon, is a disorder of the small blood vessels that causes episodic constriction (vasospasm) of arteries and arterioles in the fingers and toes in response to cold, touch, or emotional stress. The term Reynaud's is a spelling variant sometimes used in older texts, but Raynaud's phenomenon is the more common form in current medical writing.

There are two main forms: primary Raynaud's phenomenon (often called Raynaud's disease) and secondary Raynaud's phenomenon, which occurs with another underlying condition. Primary Raynaud's tends to occur in younger people, is usually symmetric, and is not associated with other diseases. Secondary Raynaud's is linked to diseases such as systemic sclerosis, lupus, rheumatoid arthritis, vasculitis, or certain blood disorders, and may be more severe or progressive. Secondary forms may show additional signs such as digital ulcers or abnormal nailfold capillaroscopy.

Attacks characteristically begin with color changes in the affected areas: pale or white (ischemia), then blue (deoxygenation), followed by red as blood flow returns. Patients may experience numbness, tingling, or pain. Attacks are typically triggered by cold or stress and can last minutes to hours.

Diagnosis is based on clinical history and examination, with tests to differentiate primary from secondary forms, including nailfold capillaroscopy, autoimmune antibody testing, and blood tests to assess inflammatory or connective tissue disease. Treatment focuses on avoiding triggers (keeping warm, smoking cessation), cardiovascular risk management, and medications to reduce vasospasm (such as calcium channel blockers) for symptom relief. In secondary Raynaud's, treating the underlying condition is essential. Severe cases may require specialized interventions.