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Raynaud’s phenomenon (pronounced /re?’no?z/) (ray-NOZ), in medicine, is a vasospastic disorder causing discoloration of the fingers, toes, and occasionally other extremities. This condition can also cause nails to become brittle with longitudinal ridges. Named for French physician Maurice Raynaud (1834 – 1881), the cause of the phenomenon is believed to be the result of vasospasms that decrease blood supply to the respective regions. Emotional stress and cold are classic triggers of the phenomenon, and the discoloration follows a characteristic pattern in time: white, blue and red.
It comprises both Raynaud’s disease (primary Raynaud’s), where the phenomenon is idiopathic,[1] and Raynaud’s syndrome (secondary Raynaud’s), where it is caused by some other instigating factor. Measurement of hand-temperature gradients is one tool used to distinguish between the primary and secondary forms.[2]
It is possible for the primary form to progress to the secondary form.[3]
The phenomenon is more common in women than men, with the Framingham Study finding that 5% of men and 8% of women suffer from it.
There is a familial component to primary Raynaud’s, and presentation is typically before two. Smoking worsens frequency and intensity of attacks, and there is a hormonal component. Caffeine also worsens the attacks. Sufferers are more likely to have migraine and angina than controls.
Secondary Raynaud’s has a number of associations:
It is important to realise that Raynaud’s can herald these diseases by periods of more than 20 years in some cases, making it effectively their first presenting symptom. This can be the case in the CREST syndrome, of which Raynaud’s is a part.
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