Raynaud's Phenomenon vs. Disease (Primary vs. Secondary)

Raynaud phenomenon (RP) = episodic digital ischemia (white → blue → red) triggered by cold/stress.

Feature	Primary (Raynaud's Disease)	Secondary (Raynaud's Phenomenon)
Associated disease	None	Scleroderma, SLE, MCTD, vasculitis, atherosclerosis
Onset age	<30 years	>30 years often
Symmetry	Symmetric	May be asymmetric
Tissue damage	Rare (ulcers, gangrene)	Common (pitting scars, ulcers, gangrene)
Nailfold capillaroscopy	Normal	Abnormal (dilated, dropout)
Autoantibodies	Negative	Positive (ANA, Scl-70, centromere)

Management

• Primary: warmth, avoid triggers, CCB (nifedipine) if needed.
• Secondary: treat underlying disease; CCB, PDE5 inhibitors, prostanoids, bosentan for digital ulcers.