Raynaud’s phenomenon is caused by exaggerated vasospasm in the extremities caused by cold or emotional stress. The classic sign is a triphasic change in skin colour:
Colour change is frequently accompanied by numbness and tingling.
There are two main types of Raynaud’s phenomenon, primary and secondary.
Primary Raynaud’s phenomenon (also called Raynaud’s disease) occurs in the absence of underlying conditions, such as connective tissue disease. Approximately 90% of all Raynaud’s phenomenon are of the primary variety.
Secondary Raynaud’s phenomenon (also called Raynaud's syndrome) occurs with underlying conditions such as connective tissue diseases e.g. scleroderma.
A small dose of a calcium channel blocker such as nifedipine or lercanidipine ameliorates this. Most sufferers need only wear a warm hat and mittens, some need electrically heated gloves, and the correct action in those with even borderline raised blood pressure is obvious. An affected nipple may be treated by application of a GTN patch for a few minutes shortly before feeding, or if resistant by oral treatment as above.
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