Raynaud's phenomenon

Abstract

Raynaud's phenomenon (RP) may affect as many 20–30% of young women [1] and have an overall prevalence in the population of approximately 10% [2]. In the UK RP is the blanket term used to describe any form of cold related vasospasm and can be further subdivided into Raynaud's syndrome (RS) where there is an associated disorder and primary Raynaud's disease (RD) where there is not. In the USA the terminology most used is primary RP and secondary RP. Australasia uses RP and RS interchangeably and thus care must be taken with literature comparisons to ensure the different terminologies are used in a standard fashion. Most workers define their population in terms of CTD association, otherwise at the start of each paper and until a standard nomenclature is accepted, this practice should continue. By far the largest group of patients presenting to their primary care physician are those with the primary disorder. However, recent studies have shown that the phenomenon may pre-date systemic illness by up to two decades. Since the development of sensitive laboratory procedures, we now know that more than half of the patients referred to hospital because of RP will have an associated systemic disease [1, 3, 4]. There is a wide spectrum of disease associated with RS including those reported in the mystery cases (i.e., drug-induced RS), that associated with thromboangiitis obliterans and with occupational vibration exposure. The best recognised of the associated disorders are the connective tissue disorders (CTDs) and RS of occupational origin (Table 1). View this table: Table 1 Conditions associated with Raynaud's phenomenon RS accompanies systemic sclerosis (SSC) in 95% of cases and also in the majority of patients with mixed connective tissue disease (MCTD) (85%). Between 10–45% of patients with systemic lupus erythematosus also suffer vasospastic attacks as do 33% of Sjogren's syndrome patients …