SPECIAL COMMENTARYPractical management of Raynaud's phenomenon – a primer for practicing physiciansRamahi, Ahmada,b; Hughes, Michaelc,d; Khanna, Dinesha,b Author Information aDivision of Rheumatology, Department of Medicine bUniversity of Michigan Scleroderma Program, University of Michigan, Ann Arbor, Michigan, USA cTameside Hospital, Tameside and Glossop Integrated Care NHS Foundation Trust, Ashton-under-Lyne dDivision of Musculoskeletal and Dermatological Sciences, The University of Manchester, Manchester, UK Correspondence to Michael Hughes, BSc (Hons), MBBS, MSc, MRCP, (UK) (Rheumatology) PhD, Consultant Rheumatologist, Department of Rheumatology, Tameside Hospital, Tameside and Glossop Integrated NHS Foundation Trust, Ashton-under-Lyne, UK. Tel: +44 114 271 1900; e-mail: [email protected] Current Opinion in Rheumatology: July 2022 - Volume 34 - Issue 4 - p 235-244 doi: 10.1097/BOR.0000000000000877 Buy Metrics Abstract Purpose of review Raynaud's phenomenon (RP) is a common vasospastic condition that results in digital hypoperfusion in response to cold and/or emotional stress and is associated with significant pain and disability. The aim of our review is to provide a practical approach for clinicians to inform assessment and management of patients with RP. Recent findings Autoantibodies and nailfold capillaroscopy are key investigations to stratify the risk of progression to systemic sclerosis (SSc) in patients RP, which was recently confirmed in the multicenter, very early diagnosis of systemic sclerosis (VEDOSS) project. Research has explored the complex lived-patient experience of RP including digital vasculopathy in SSc and has highlighted the need for outcome measure development to facilitate research in the field. Pharmacological treatment strategies vary significantly internationally and there is continued interest in developing surgical approaches. Summary We provide a practical and up-to-date approach to inform the assessment and management of patients with RP including guidance on drug initiation and escalation. Calcium channel blockers are first-line treatment and can be initiated by primary care physicians. We also highlight second-line drug therapies used for refractory RP and the potential role for surgical intervention. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.