title: Raynauds phenomenon - assessment and differential diagnoses.
abstract: Raynauds phenomenon (RP) is characterised by paroxysmal reversible episodes of vasospasm, usually involving peripheral small vessels of the fingers or toes and resulting in a triple-colour change starting with pallor and followed by cyanosis and erythema. Attacks are typically triggered by cold or emotional stress. The diagnosis of RP can be made on the basis of the patients clinical symptoms. Primary RP occurs without underlying disease and is considered a benign condition. A normal erythrocyte sedimentation rate, negative testing for antinuclear antibodies, normal nailfold capillaries and the absence of structural micro- or macrovascular damage and other diseases lead to the diagnosis of primary RP. Digital photoplethysmography and pulse contour analysis can be used as an additional tool to exclude structural macro- or microvascular disease. In contrast, secondary RP is associated with other diseases, mainly connective tissue diseases such as systemic sclerosis. If there is a suspicion of secondary RP, a thorough laboratory and vascular assessment is required to make the diagnosis of underlying disease. Acrocyanosis and erythromelalgia are additional functional vascular disorders that can be easily distinguished when patients are carefully assessed for their history and clinical symptoms.
authors.affiliation: 1 Medical Practice of Angiology and Haemostaseology, Praxis am Grüneburgweg, Frankfurt, Germany.
authors.forename: Birgit
authors.initials: B
authors.lastname: Linnemann
authors.forename: Matthias
authors.initials: M
authors.lastname: Erbe
mesh_terms: D003937:Diagnosis, Differential; D006801:Humans; D011237:Predictive Value of Tests; D011379:Prognosis; D011928:Raynaud Disease / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D012307:Risk Factors
keywords: Raynauds phenomenon; acrocyanosis; digital photoplethysmography; erythromelalgia; microvascular disease; nailfold capillaroscopy