Raynaud’s phenomenon: how to recognize it and why capillaroscopy makes the difference

Raynaud’s phenomenon presents with recurrent episodes in which the fingers (and sometimes toes) become pale, bluish, or reddened, often accompanied by tingling or pain, especially in response to cold or stress.

“It is often perceived as a minor inconvenience, but in reality it may signal systemic diseases. This is why it is important not to overlook its signs. The problem arises when patients downplay their symptoms, attributing them solely to the cold: the risk is losing valuable time for diagnosis,” emphasizes Dr. Serino.

Periungual capillaroscopy, a quick, non-invasive, and painless examination, is now a key tool for the early diagnosis of certain autoimmune and rheumatologic diseases, as it allows visualization of the microcirculation at the nailfold.

Thanks to this technique, we can distinguish between:

• Primary Raynaud’s, which is more common and generally benign;
• Secondary Raynaud’s, associated with rheumatologic or autoimmune diseases such as scleroderma, lupus, or rheumatoid arthritis.

Early diagnosis makes it possible to:

• initiate targeted clinical monitoring;
• prevent complications;
• begin any necessary treatments promptly.

In rheumatology, as in many other fields of medicine, intervening in the early stages significantly improves prognosis and patients’ quality of life.

Capillaroscopy allows the visualization of capillaries at the nailfold using a high-resolution digital microscope. This enables us to:

• detect any microcirculatory alterations that may indicate the onset of a systemic disease;
• identify early vascular abnormalities before the clinical symptoms of autoimmune diseases appear.

It is a safe exam, with no contraindications, and can be performed immediately.

Its importance is also recognized by international guidelines: EULAR (European Alliance of Associations for Rheumatology) recommends capillaroscopy as a first-line investigation in patients with suspected Raynaud’s.

Capillaroscopy is particularly indicated for:

• anyone experiencing frequent episodes of changes in finger color;
• young women between the ages of 20 and 40 (the most commonly affected group, though it is not an exclusively female condition);
• individuals with a family history of autoimmune diseases or who already suffer from rheumatologic conditions.

“The message is clear: early diagnosis makes the difference, and prevention is an integral part of care. The body often sends subtle signals—learning to recognize them makes it possible to protect one’s health with simple and safe tools, anticipate treatment pathways, and improve quality of life,” concludes Dr. Serino.