Il fenomeno di Raynaud: diagnostica

Abstract

Raynaud’s phenomenon (RP) is a vasospastic disorder characterized by episodic color changes of blanching, cyanosis, and hyperaemia in response to cold and/or emotional stress. Although most typically noted in the fingers, circulation of the toes, ears, nose and tongue is also frequently affected. Population studies have shown that RP in adults is more common in women than in men, with prevalence estimates ranging from 4% to 30%. Geographic variations in the prevalence reflect differences in climate.

RP may be a primary or a secondary process. LeRoy and Medsger suggested criteria for primary RP: symmetric attacks, the absence of tissue necrosis, ulceration or gangrene, the absence of a secondary cause, negative antinuclear antibodies, normal nailfold capillaroscopy and a normal erythrocyte sedimentation rate. Among the CTDs, systemic sclerosis has the highest frequency of RP.

Finding a cause for RP requires a knowledge of the patient’s occupational, smoking and drug history, physical examination, nailfold capillaroscopy, routine laboratory tests and autoantibodies. Furthermore, RP should be distinguished from acrocyanosis, a condition characterized by continuous cyanosis of the hands or feet that is worsened by cold temperature.’