Raynaud's Syndrome,an Enigma After 130 Years

Abstract

The recent literature concerning Raynaud's syndrome is reviewed. Ray naud's syndrome is as common as hypertension and diabetes. In spite of its generally benign character, it causes a lot of discomfort to individuals and sick ness absenteeism to society, especially in the colder regions of the world.

The etiology remains an enigma 130 years after its first description, perhaps even more so than ever before, the many new theories proposed in the litera ture. Clearly, in a condition where seventy different etiologic theories are advo cated, the culprit lesion is obviously missing, or there is not a culprit lesion but an accumulation of conditions having nothing in common but a few symptoms. Moreover a Raynaud attack may result, not from a single event, but from a cascade of events, just as, for example, hemostasis does.

Controversy about diagnosis exists all over. For example, how does one make a diagnosis? Patient history has been considered unreliable. A standardized cold test, though highly reproducible in the authors' hands, is far from common property.

Raynaud's syndrome is a condition for which thirty-eight therapies have been advocated in the last three years, but the curative answer is still to come.