Raynaud's

Key points

• Raynaud's phenomenon may be primary (Raynaud's disease, no underlying cause) or secondary (associated with an underlying condition)
• Primary Raynaud's disease typically presents in young women with symmetrical, episodic digital colour change (white → blue → red) triggered by cold or stress, with no underlying cause found
• Features suggesting a secondary cause rather than primary disease: onset after 40 years, unilateral symptoms, presence of autoantibodies, features suggesting rheumatoid arthritis or SLE (e.g. arthritis, recurrent miscarriages)
• Secondary causes include connective tissue disorders (systemic sclerosis, SLE, RA), drugs (beta-blockers, ergot), and occupational vibration exposure
• Management: keep the extremities warm; calcium channel blockers (e.g. nifedipine) are first-line pharmacological treatment