Raynauds Phenomenon

1. RAYNAUD’S
PHENOMENON

2. WHAT IS RAYNAUD’S PHENOMENON
➔ Episodic digital ischemia
➔ Sequence being digital blanching, cyanosis and rubor of
finger and toes
➔ Mostly seen after cold exposure
➔ Changes revert after warming

3. PHASES IN RAYNAUD’S
1. Ischemic phase
Due to vasospasm of digital arteries
Pallor followed by cyanosis
Pallor due to vasospasm f/b cyanosis due to dilatation of
capillaries and venules
Symptoms of tingling/paresthesia/numbness

4. 2. Reactive hyperemia
Bright red color
HENCE TRIPHASIC COLOR RESPONSE…… PALE, BLUE, BRIGHT
RED COLOR

5. TYPES OF RAYNAUD PHENOMENON
Primary and Secondary
Primary
Common in females (5 times common)
20-40 yrs
Fingers > Toes
History of excessive perspiration
10% cases- Sclerodactyly (Thickening and tightening of digital
subcutaneous tissue)

6. SECONDARY RAYNAUD’S PHENOMENON
❖ Collagen Vascular Diseases
Systemic sclerosis (SCLERODERMA)- 80-90%
SLE - 20 %
Dermatomyositis or Polymyositis- 30 %
Rheumatoid Arthritis
❖ Atherosclerosis, Thromboangitis Obliterans - Cigarrete smokers

7. ❖ Pulmonary Hypertension - Primary
❖ Blood dyscrasias
Cryoglobulinemia, Myeloproliferative disorders
❖ Drugs
Beta agonists, Vincristine, Bleomycin, Cisplatin

8. TREATMENT
Reassurance
Warm clothing
Avoid tobacco, smoking
Drugs

9. DRUGS
Calcium Channel Blockers
Nifedepine, Amlodepine
Alpha 1 antagonist
Prazosin
Phosphodiesterase 5 inhibitor
Sildenafil