Raynaud's Phenomenon and Scleroderma

By Richard Silver, M.D., Professor of Medicine, Medical University of South Carolina (originally published in "Scleroderma Voice," 2002 Issue #1)

Question: I have been diagnosed with Raynaud's phenomenon. I recently learned that there is a close link between Raynaud's and scleroderma. However, I understand there may be a delay of as long as 20 years from the first signs of Raynaud's until the appearance of other signs of scleroderma.

Answer: A close relationship between Raynaud's phenomenon and scleroderma does indeed exist. About 95% of all scleroderma patients experience Raynaud's phenomenon (tri-color changes in the fingers and/or toes induced by cold exposure).

On the other hand (no pun intended), Raynaud's phenomenon is a common condition in the adult population, and most people with Raynaud's phenomenon are otherwise healthy. Only about 5% of them have (or will subsequently develop) a connective-tissue disease such as scleroderma.

Two tests seem to have value for determining which Raynaud's phenomenon sufferers may be at risk:

1. A blood test for antinuclear antibodies, especially tests for specific auto antibodies such as anti-centromere or anti-scleroderma-70 antibodies; and
2. Nailfold capillary microscopy.

The former is readily available and can be ordered by your primary care doctor.

The latter is a non-invasive study of the small blood vessels in your skin, which often requires consultation with a rheumatologist trained to conduct such examinations.