Raynaud phenomenon

Raynaud's phenomenon is a common clinical disorder characterized by recurrent vasospasm episodes of digital arteries, arterioles, pre-capillary and post-capillary venules triggered by exposure to cold or emotional stress. RP can be classified as primary (idiopathic), or secondary to several diseases or conditions. The pathogenesis of RP is still not entirely clear or understood, but recent insights into the pathogenic mechanisms underlying Raynaud's phenomenon include vascular, neuronal and intravascular abnormalities which may identify crucial key points and potential targets for therapeutic intervention.In this review we summarize the epidemiology, pathogenesis, clinical manifestations and assessments as well as the recent advances in therapeutic approaches.An extensive review of recent literature was conducted, according to the guidelines proposed at the PRISMA statement. MEDLINE database (PubMed) and Thomson Reuters Web of Knowledge platform were searched for articles published in peer-reviewed journals and published in English language. The keyword search terms included: Raynaud phenomenon, epidemiology, pathogenesis, thermoregulation, endothelium dysfunction, risk factors, clinical features, nailfold videocapillaroscopy and treatment.Inclusion criteria were: (1) Randomized controlled trials (2) Reviews, systematic reviews and meta-analysis of randomized controlled trials (3) English language. Studies lacking clinical end points of relief, case reports and open label trials were excluded.