Raynaud's phenomenon as an early sign of connective tissue diseases.

Raynaud's phenomenon (RP) is seen in 5-10% of the population and generally follows an indolent course. In some cases it may be the first sign of a connective tissue disease (CTD). In patients referred to the clinician because of their RP, obviously the more severe cases, CTD, in particular scleroderma, will develop, however, in a considerable percentage. Risk factors for the evolution of CTD are (a) the severity of RP at onset, (b) a positive test for antinuclear antibodies, (c) nailfold capillary abnormalities, and (d) older age at onset. Patients with RP who are at risk for the development of CTD should be followed in order to diagnose (and treat) a developing CTD as early as possible.