RAYNAUD’S
DISEASES
REPORTER:
CARLA JEAN SARTO
MARY THONIE
TUÑACAO
JAYNA-MAE N. YGOT
DEFINITION
Raynaud's (ray-NOSE) disease causes some areas
of the body — such as fingers and toes — to feel
numb and cold in response to cold temperatures
or stress. In Raynaud's disease, smaller blood
vessels that supply blood to the skin narrow. This
limits blood flow to affected areas, which is called
vasospasm.
OTHER NAMES FOR THIS
CONDITION ARE:
Raynaud's phenomenon.
Raynaud syndrome.
ETIOLOGY
1. Vasospasm: Temporary narrowing of blood vessels in
response to cold or stress.
2. Abnormal blood vessel response: Blood vessels
overreact to stimuli, leading to vasoconstriction.
3. Genetic predisposition: Family history may play a role.
4. Autoimmune disorders: Associated with conditions like
scleroderma, lupus, and rheumatoid arthritis.
5. Environmental factors: Exposure to cold, vibration, or
certain chemicals may trigger symptoms.
HISTORY
This condition was first described by French physician
Maurice Raynaud (1834-1881) in 1862 1,10, however,
the eponym 'Raynaud phenomenon' was first coined by
Sir Jonathan Hutchinson (1828-1913), an English
physician and surgeon, over thirty years later in 1893
RAYNAUD'S DISEASE
INCIDENCE
varies between 2-20% in the population, with primary
Raynaud's syndrome accounting for 60-90% of cases.
Primary Raynaud's syndrome: More common,
representing 60-90% of cases, with a higher incidence in
women, affecting up to 7 times more often than men. -
Secondary Raynaud's syndrome: Represents about 20% of
cases, often associated with underlying diseases like
autoimmune disorders, such as systemic sclerosis, systemic
lupus erythematosus, and rheumatoid arthritis. -
and treatment.
Continue...
Age and gender: Typically affects young to middle-aged adults, with onset
often occurring between 15 and 40 years old, and women being more
frequently affected.
Triggers: Cold temperatures, stress, and certain occupations involving
vibrating tools can trigger Raynaud's episodes. Some autoimmune diseases
associated with Raynaud's phenomenon include ²: - Systemic sclerosis: 90%
of cases - Systemic lupus erythematosus: 10-44% of cases.
Rheumatoid arthritis: Common initial sign of Raynaud's disease
Sjögren's syndrome: 33% of cases It's essential to note that Raynaud's
disease can have serious consequences if left untreated, such as skin
damage, ulcers, and gangrene. If you're experiencing symptoms, consult a
healthcare professional for proper diagnosis
SIGN &
SYMPTOMS
Raynaud’s causes episodes of reduced blood flow to areas like
fingers, toes, nose, or earlobes, often triggered by cold or stress.
Affected areas may turn pale or white (pallor), feel cold, numb,
and painful. When blood flow returns, the skin may turn red
(rubor), swell, and cause a tingling or "pins and needles"
sensation. Not all patients experience all color changes. During
pregnancy, symptoms usually improve due to increased blood
flow, but it can still occur in breastfeeding mothers, affecting the
nipples
PREDISPOSING FACTORS PRECIPITATING FACTORS
Female Exposure to cold temperature
Age under 30 Emotional stress
Genetics Autoimmune diseases (e.g.,
Vascular abnormalities Scleroderma)
Neural abnormalities Vibration/trauma Certain drugs
Activates sympathetic nerves
Release of norepinephrine
Stimulates alpha-2 adrenergic
receptors
Vasoconstriction of blood vessels
Decreased blood flow to
fingers/toes
Clinical Manifestations (Color Changes)
• White (Pallor) – Lack of blood flow
• Blue (Cyanosis) – Deoxygenated blood
• Red (Rubor) – Return of blood flow (reactive hyperemia)
• Tingling, numbness, or pain may occur
• Primary Raynaud’s – No
underlying disease, milder
• Secondary Raynaud’s –
Associated with autoimmune
DIAGNOSTIC PROCEDURES (RAYNAUD'S SYNDROME)
Raynaud's syndrome diagnosis primarily relies on patient history and physical
examination, often supplemented by nailfold capillaroscopy and blood tests.
Nailfold capillaroscopy helps differentiate between primary and secondary
Raynaud's, while blood tests can identify underlying conditions. Dynamic Doppler
sonography may be used to assess blood flow, especially in cases where an artery
blockage is suspected.
Raynaud syndrome (also known as Raynaud's phenomenon or Raynaud's disease)
is a condition characterized by episodes of reduced blood flow to the fingers and
toes, usually triggered by cold or stress. Diagnosis focuses on distinguishing
primary Raynaud's (more common, benign) from secondary Raynaud's (associated
with autoimmune or connective tissue diseases).
Diagnostic Procedures for Raynaud Syndrome
1. Clinical Evaluation
History: Review symptoms (color changes—white, blue, red), triggers
(cold/stress), symmetry of attacks, duration, and frequency.
Physical exam: Focus on hands, feet, nails, and skin for signs of
underlying conditions (e.g., sclerodactyly, ulcers, joint deformities).
2. Nailfold Capillaroscopy
Purpose: To assess capillary abnormalities.
Method: A drop of oil is placed on the cuticle area and viewed under a
microscope.
3. Blood Tests
Used to detect underlying autoimmune or connective tissue disease: ANA (Antinuclear
Antibody)
ESR (Erythrocyte Sedimentation Rate)
CRP (C-reactive protein)
Specific antibodies (if ANA positive or suspicion high):
Anti-Scl-70 (Systemic sclerosis)
Anti-centromere
Anti-RNP
Anti-SSA/SSB (Sjogren’s)
Rheumatoid factor (RF)
Anti-dsDNA (Lupus)
4. Digital Blood Flow Tests (Optional)
Cold stimulation test: Assess recovery time of skin temperature after cold exposure.
Laser Doppler flowmetry or plethysmography: Measures blood flow in fingers.
MANAGEMENT
CONSERVATIVE TREATMENT (Non-Medication)
These are simple lifestyle changes to reduce attacks:
🧤 Stay Warm: Wear gloves, warm socks, and layer clothes especially in cold
weather.
🚫 Avoid Triggers: Stay away from cold places and reduce emotional stress.
🚭 Stop Smoking: Nicotine narrows blood vessels and worsens Raynaud’s.
🧘 Manage Stress: Practice relaxation techniques like deep breathing, yoga,
or meditation.
Protect Hands and Feet: Avoid injuries, vibrations (like using power tools),
and tight rings or shoes.
🚿 Warm Water Soaks: Place hands/feet in warm (not hot) water during
SURGICAL MANAGEMENT
Surgical Management (Rare & Last Option)
Used only if severe tissue damage or ulcers occur:
🧠 Sympathectomy:
A surgical procedure that cuts nerves responsible
for narrowing blood vessels.
Can be done as a nerve block or surgical removal of
sympathetic nerves.
May provide temporary relief, but results vary.
💉 Botox injections:
In some cases, Botox is injected into affected hands
to improve blood flow and reduce pain.
NURSING MANAGEMENT
Nurses help support the patient through:
🩺 Assessment:
Monitor frequency and duration of attacks.
Observe for signs of ulcers, color changes, or tissue damage. ❤️Patient Education:
Teach the importance of staying warm and avoiding triggers.
Explain how and when to take medications.
Encourage smoking cessation and stress management.
👣 Skin and Extremity Care:
Teach proper foot and hand hygiene.
Monitor for signs of infection or wounds.
Avoid tight shoes or pressure on the feet and hands.
✨ Emotional Support:
Provide support, especially for patients anxious about their symptoms.
Refer to counseling if stress or anxiety worsens symptoms.
THANK
YOU
