Images in Clinical Medicine
Acute Episode of Raynaud's Disease
N Engl J Med 2002; 347:992September 26, 2002
- Article
Figure 1 A 54-year-old man had an acute primary episode of Raynaud's disease after surfing for 80 minutes in water that was 21°C. The distinctive asymmetric pallor of the terminal phalanges of the fourth digit on the right hand persisted for 40 minutes. A sharp demarcation between the second and third phalangeal joints was evident, but no other symptoms were apparent. The pallor spontaneously resolved without cyanosis or redness of the affected area. Medical evaluation subsequently revealed no disorder known to cause secondary Raynaud's phenomenon.
Raynaud's phenomenon is manifested by episodes of pallor and cyanosis of the digits in response to cold or emotion. Raynaud's disease accounts for 60 percent of cases, and 40 percent of cases are secondary to other diseases or causes. The onset is typically between the ages of 20 and 40 years, and it is more common in women than men. The associated pallor results from intense vasoconstriction or spasm of the walls of the digital artery as a result of hypersensitivity to the vasoconstrictive effects of cold.
Marsha J. Bluto, R.N., B.Bus.
Daniel A. Norman, M.D.
Barton Memorial Hospital, South Lake Tahoe, CA 96150
