Secondary Raynaud’s Phenomenon: Focus on Rheumatic Diseases

Although much less common than primary Raynaud’s cases, patients with secondary Raynaud’s phenomenon often represent a substantially greater clinical challenge. Distal vasospasm may be aggravated by other disease manifestations which impact on the choice of therapy and responsiveness to vasodilator approaches. There are several important diseases that are associated with Raynaud’s phenomenon and these are distinguished by the underlying systemic disease and progression of the vascular process. This chapter discusses the key characteristics of the associated Raynaud’s phenomenon in autoimmune rheumatic disease and potential link with COVID-19. The review will also highlight the central role of Raynaud’s phenomenon in the emerging concepts of interstitial pneumonia with autoimmune features and very early stage of systemic sclerosis. It will review management strategy with appropriate investigations and treatment approach for Raynaud’s phenomenon in this context. The specific challenges of this group of patients that often have complications related to vascular insufficiency are considered, and the evidence supporting disease-specific aspects of treatment is summarised.