Raynaud’s Phenomenon RP is a popular vasospastic disorder described by colour alteration of the hands digits (and oftentimes the feet) in reply to cold or/and passionate stressors (Wigley, 2002). In almost all patients RP is idiopathic [primary Raynaud phenomenon (PRP)], but less frequently may become secondary (SRP) to an implied illness procedure, e.g. SSc (Herrick, 2012).

Occupational Raynaud’s phenomenon is linked to the usage of vibrating instruments, as well a considerable proportion of patients may be cured by an early alteration in work. In those over 60 years of age, however, Raynaud’s phenomenon is usually an outcome of atherosclerotic obstructive arterial illness, and screening for and therapy of the risk agents is suitable (Belch and Ho, 1996).

Primary Raynaud phenomenon (RP) is actually a benign situation; it is oftentimes temporal in nature and may develop or vanish with time in one-third or more of ill people over 7 to 14 years of pursuit (Suter et al., 2005).

Anyway, numerous patients with primary RP announce that it owns significant effect on their quality of life because of cold and inconvenient hands and fingers. This is especially true in people who have careers that do not permit efficient cold avoidance. A universal survey of the self-reported effect of RP found higher than 25 percent of ill people included decreased quality of life, portraying feelings of confusion and changes in social and physical role (Murphy et al., 221).

It is remarkable that a survey of 443 ill people with self-reported primary or secondary Raynaud's phenomenon from 15 lands found that 64 percent recorded an indigent or very indigent current capability to block/control Raynaud's phenomenon attacks in spite of lifestyle alterations and prescribed medicines (Hughes et al., 2015).

The fingers are the most usually influenced body area in Raynaud's phenomenon and signs are bilateral in 90% of sick people. Asymmetry can become a foreteller of secondary RP (Pauling et al., 2019).

By compare, sick people with secondary RP are more probable to own severe attacks and advanced or sustained illness. Patients with linked systemic rheumatic illness, especially systemic sclerosis (SSc, scleroderma), may improve constant digital ischemia demanding aggressive interference, which is not constantly efficient (Hughes et al., 2015).

Treatments designed to decrease emotional stress may become useful. Avoiding factors that generate vasoconstriction is as well essential (e.g., serotonin-receptor agonists, sympathomimetic medications, ergotamine, and clonidine). Smoking can decrease digital blood flow (Goodfield et al., 1990) and should be bypassed by sick people with Raynaud's phenomenon, but epidemiologic surveys have not obviously explained a link between Raynaud's phenomenon and smoking (Palesch et al., 1999).

Nonpharmacologic Treatment: The avoidance of cool temperatures is the preferable method to block an event of Raynaud's phenomenon. Protecting the entire body warm via wearing loose-fitting clothes, headwear, stockings, and gloves in cool weather is a central plan. The thermoregulatory vessels and digital arteries of the skin are mainly under sympathetic adrenergic monitoring. Emotional stress alone can stimulate digital vasospasm, as well anxiety can aggravate cold-induced Raynaud's attacks (Brown et al., 2001).

Pharmacological Treatment: Those patients not responding to common measures should be presented medication treatment as mentioned by Herrick (2017) like: Calcium channel blockers, Phosphodiesterase type 5 inhibitors (PDE5 inhibitors), and other medications occasionally prescribed contain angiotensin-converting enzyme (ACE) inhibitors, α blockers, nitrates, the selective serotonin receptor uptake inhibitor fluoxetine, and angiotensin II receptor antagonists.

The targets of treatments are to decrease the severity of attacks as well, to block tissue injury and loss in the toes and fingers. So, by Mapping the Nano-Journey’s Feelings of Raynaud’s Phenomenon, we can enjoy and try to become better every day.

References:

Belch, J.F. and Ho, M. (1996). Pharmacotherapy of Raynaud’s Phenomenon. Drugs, 52, 682–695.

Brown, KM., Middaugh, SJ., Haythornthwaite, JA. et al. (2001). The effects of stress, anxiety, and outdoor temperature on the frequency and severity of Raynaud's attacks: the Raynaud's Treatment Study. J Behav Med, 24:137-153.

Goodfield, MJ., Hume, A., & Rowell, NR. (1990). The acute effects of cigarette smoking on cutaneous blood flow in smoking and non-smoking subjects with and without Raynaud's phenomenon. Br J Rheumatol, 29:89-91.

Herrick, AL. (2012). The pathogenesis, diagnosis and treatment of Raynaud phenomenon. Nat Rev Rheumatol, 8: 469−79.

Herrick, AL. (2017). Evidence-based management of Raynaud's phenomenon. Therapeutic advances in musculoskeletal disease, 9(12), 317–329.

Hughes, M., Snapir, A., Wilkinson, J. et al. (2015). Prediction and impact of attacks of Raynaud's phenomenon, as judged by patient perception. Rheumatology, 54:1443.

Murphy, SL., Lescoat, A., Alore, M. et al. (2021). How do patients define Raynaud's phenomenon? Differences between primary and secondary disease. Clin Rheumatol, 40:1611.

Palesch, YY., Valter, I., Carpentier, PH. et al. (1999). Association between cigarette and alcohol consumption and Raynaud's phenomenon. J Clin Epidemiol, 52:321-328.

Pauling, J. D., Saketkoo, L. A., Matucci-Cerinic, M. et al. (2019). The patient experience of Raynaud's phenomenon in systemic sclerosis. Rheumatology (Oxford, England), 58(1): 18–26.

Suter, LG., Murabito, JM. et al. (2005). The incidence and natural history of Raynaud's phenomenon in the community. Arthritis Rheum, 52:1259.

Wigley, FM. (2002). Clinical practice. Raynaud’s phenomenon. N Engl J Med, 347: 1001-8.