Attention all crews! Spasm of small extremity arteries in response to cold or stress has been detected. Fingers turn white (ischemia), then blue (cyanosis), then red (reperfusion). Normalization of vascular reactivity is required.

Syndrome Type Diagnostics

Peripheral communications engineers:

• Distinguish primary (no underlying disease) from secondary Raynaud's syndrome
• For secondary — identify the underlying disease (scleroderma, lupus, vibration disease)
• Perform capillaroscopy, immunological workup
• Assess for tissue damage (ulcers)

Cold Protection — Primary Measure

Thermoregulation crew:

• Keep the entire body warm (not just the hands)
• Warm mittens (better than gloves), socks, hat
• Warm hands before going out into the cold
• Use chemical or electric hand warmers
• Avoid air-conditioned spaces

Lifestyle Modifications

Prevention crew:

• Quit smoking — critically important
• Avoid beta-blockers, ergotamines, vasoconstrictors
• Stress management
• Limit caffeine
• Avoid vibration

Medication Therapy

Pharmaceutical crew:

• Calcium channel blockers (nifedipine, amlodipine)
• Sildenafil for severe cases
• Topical nitrates
• Intravenous prostaglandins for critical ischemia

Treatment of Underlying Disease

Specialized crews:

• For secondary syndrome — therapy for the underlying condition
• Immunosuppression for autoimmune diseases

Project Completion

With proper prevention and treatment, attacks will become less frequent and milder, and tissue damage will be prevented. Prognosis: primary syndrome is usually benign. Secondary requires control of the underlying disease.