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Raynaud Phenomenon

Kelsey E. Phelps, MD Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Idiopathic intermittent episodes of vasoconstriction of digital arteries, precapillary arterioles, and cutaneous arteriovenous shunts in response to cold, emotional stress, or blunt ...

DIAGNOSIS

HISTORY

  • Primary

    • Symmetric attacks involving fingers

    • Family history of connective tissue disorder

    • Absence of tissue necrosis, ulceration, or gangrene

    • If after ≥2 years of symptoms, no abnormal c...

TREATMENT

Assess using a Raynaud Condition Score. 

GENERAL MEASURES

  • Dress warmly, wear gloves, and avoid cold temperatures.

  • During attacks, rotate the arms in a windmill pattern or placing the hands unde...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

Avoid exposure to cold; reassess for secondary causes. 

Patient Monitoring

Manage fingertip ulcers and rapidly treat infection. 

DIET

No special diet 

PATIENT EDUCATION

REFERENCES

1
Barrett ME, Heller MM, Stone HF, et al. Raynaud phenomenon of the nipple in breastfeeding mothers: an underdiagnosed cause of nipple pain. JAMA Dermatol.  2013;149(3):300–306. [View ...

ADDITIONAL READING

  • Herrick AL. Contemporary management of Raynaud’s phenomenon and digital ischaemic complications. Curr Opin Rheumatol.  2011;23(6):555–561. [View Abstract on OvidMedline]

  • Huisst...

SEE ALSO

Algorithm: Raynaud Phenomenon 

CODES

ICD10

  • I73.00 Raynaud’s syndrome without gangrene

  • I73.01 Raynaud’s syndrome with gangrene

ICD9

443.0 Raynaud’s syndrome 

SNOMED

  • 266261006 Raynaud’s phenomenon (finding)

  • 361131008 Isolated primary Raynau...

CLINICAL PEARLS

  • Raynaud phenomenon is a clinical diagnosis.

  • Provocative testing is not recommended.

  • Initial presentation of Raynaud phenomenon after age 40 years suggests underlying (secondary) disease.

  • ...

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