Scleroderma is a chronic autoimmune disease characterized by areas of hardened skin affecting various parts of the body. It is caused by an excessive buildup of collagen protein that hardens connective tissue. Although scleroderma mostly affects the skin, it can also damage internal organs and blood vessels.

Almost all scleroderma patients develop what is called secondary Raynaud’s phenomenon, a condition where the fingers and toes feel numb, prickly and frigid in response to cold temperatures or stress. This is caused by the excess collagen that narrows small blood vessels in the fingers and toes.

Raynaud’s phenomenon is among the earliest symptoms of scleroderma, but most people with primary Raynaud’s phenomenon do not develop scleroderma.

How is Raynaud’s phenomenon diagnosed?

Raynaud’s phenomenon is usually easy to diagnose, but it may be more difficult to determine whether or not it is secondary to scleroderma.

The doctor will usually ask the patient simple questions about cold-induced color changes in their fingers and toes, and if family history of other diseases that may be associated with Raynaud’s phenomenon, such as lupus, exists. They may also request blood tests to look for antinuclear antibodies (ANA) and a nailfold capillaroscopy, which is an examination of the capillary circulation at the base of the fingernails under a microscope or magnifier to identify any scleroderma-related damage to capillaries. The presence of ANA in the blood may also be an indicator of an immune condition such as scleroderma.

How is secondary Raynaud’s phenomenon treated?

Regardless of whether or not Raynaud’s phenomenon is caused by scleroderma, its symptoms can be treated by taking measures such as dressing warmly, avoiding prolonged cold exposure, and quitting smoking.

There are no treatments approved by the U.S. Food and Drug Administration (FDA) for Raynaud’s phenomenon, but prescription medications like calcium channel blockers or vasodilators, that improve blood flow by widening vessels and lower blood pressure, may help.

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