[The therapy of Raynaud's phenomenon].

Management of Raynaud's phenomenon is essentially "symptomatic". Some hygienic-behavioral rules intended to eliminate all factors (cold, cigarette smoking, drugs, traumata) apt to trigger the phenomenon are essential. A number of drugs have been suggested for treatment: Nifedipine had been found to be effective in reducing frequency and duration of vasospastic attacks thanks to its mainly vasodilatory action, to its ability to influence platelet activity as well as to its antithrombotic effect. Also the most recent generation of calcium-channel blockers (nicardipine felodipine, isradipine, etc.) were found to have therapeutic efficacy comparable to that of nifedipine, with the added advantage of a once daily dosage. Ketanserin, a serotoninergic antagonist, is a valid alternative to calcium-channel blockers for treatment of Raynaud's phenomenon in as much as it can reduce frequency, duration and severity of vasospastic attacks, although not all authors agree upon this point. The use of prostanoids is usually reserved for cases of Raynaud's phenomenon associated with systemic sclerosis accompanied by extensive trophic disorders. Surgery is indicated only in selected cases.