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Raynaud’s phenomenon 

Raynaud’s phenomenon
Raynaud’s phenomenon

Michael Jenkins

and Maresa Carulli

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date: 07 July 2020

It is not uncommon for patients with a variety of perfusion disorders of the hands to be referred to a vascular clinic. Such patients are often labelled under the umbrella term of ‘? Raynaud’s’, but this is not strictly accurate, and within this group there may be a number of distinct conditions with differing pathophysiologies. In most cases, the conditions can be generally divided into primary or secondary causes based on aetiology. The former are termed idiopathic, tend to present at a younger age, and exhibit less serious symptoms. Secondary causes can be numerous, but connective tissue disorders need to be excluded and/or treated. At the most basic level, Raynaud’s syndrome, acrocyanosis, and erythromelalgia all result from a disturbance in the control mechanisms regulating vasoconstriction and dilatation. In erythromelalgia, the hyperaemic phase predominates resulting in hot red hands; in acrocyanosis, vasoconstriction of the capillary bed and/or arteriovenous shunting leads to a bluish hue; patients with Raynaud’s syndrome typically describe a triphasic colour change. In all cases, attacks can be triggered by climatic changes or emotional stress, but the pathophysiology remains poorly understood.

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