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Clinical manifestations and diagnosis of the Raynaud phenomenon

Fredrick M Wigley, MD
Section Editor
John S Axford, DSc, MD, FRCP, FRCPCH
Deputy Editor
Monica Ramirez Curtis, MD, MPH


The Raynaud phenomenon (RP) is an exaggerated vascular response to cold temperature or emotional stress. The phenomenon is manifested clinically by sharply demarcated color changes of the skin of the digits. Abnormal vasoconstriction of digital arteries and cutaneous arterioles due to a local defect in normal vascular responses is thought to underlie the disorder.

RP is considered primary if these symptoms occur alone without evidence of any associated disorder. By comparison, secondary RP refers to the presence of the disorder in association with a related illness, such as systemic lupus erythematosus and systemic sclerosis (SSc; scleroderma).

The clinical manifestations and diagnosis of the Raynaud phenomenon are reviewed here. The pathogenesis and treatment of this disorder are presented separately. (See "Pathogenesis of the Raynaud phenomenon" and "Initial treatment of the Raynaud phenomenon" and "Treatment of the Raynaud phenomenon resistant to initial therapy".)


Establishing the true prevalence of Raynaud phenomenon (RP) is hampered by the lack of a well-defined reproducible "gold standard" diagnostic test. Cold hands and feet are a normal physiological response to cold exposure that, to preserve heat, cools the surface skin and causes skin color changes; whereas RP is an exaggerated vascular response to cold temperature or emotional stress. Although survey criteria vary, most investigators agree that a history of at least two color changes (pallor and cyanosis) after cold exposure is necessary for a definite diagnosis.

Community-based surveys have been performed to estimate the prevalence of RP in the general population. In these surveys, estimates of the prevalence of RP have ranged from 3 to 20 percent in women and 3 to 14 percent in men.

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Literature review current through: Nov 2017. | This topic last updated: Jan 18, 2017.
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