Raynaud's phenomenon (RP) is a clinical picture characterized by the presence of recurrent episodes of vasospasm that is precipitated by cold or other stimuli and especially affects the fi ngers and/or toes. It may be primary or idiopathic or secondary and be due to many causes, among which connective diseases, and specifi cally scleroderma, stand out. Primary RP does not generally require drug treatment, only requiring general measures. Calcium channel antagonists continue to be the drug of fi rst choice. However, when RP is severe and is accompanied by digital ulcers/tissue necrosis, the therapeutic regime must be individualized and combinations should be established with difference drugs such as prostanoids, bosentan, sildenafi l, ntiaggregants/anticoagulants, antibiotics and analgesics. © 2008 Elsevier España, S.L. All rights reserved.