Raynaud's phenomenon: When benign, when serious?

Episodic color changes and/ or discomfort in the digits, precipitated by cold or emotion, is sufficient evidence of Raynaud's phenomenon. Symptoms of primary Raynaud's phenomenon, including digital paresthesias, numbness, or discomfort, are mild and often ignored by the patient - as long as digital ulcers do not develop. In persons without antinuclear antibodies and who have no abnormalities on nail fold microscopy, Raynaud's phenomenon does not usually progress to a systemic connective tissue disease. Conservative measures generally relieve symptoms; consider therapy with a calcium channel blocker if symptoms are bothersome. Suspect secondary Raynaud's phenomenon when the symptoms occur in a young child, any male, or a woman with disease onset after age 35, or in a patient with associated digital ulcers. Treat these patients as you would those who have primary disease; however, symptoms may be less responsive to therapy.