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Most patients with this condition experience <jats:styled-content style=\"fixed-case\">R<\/jats:styled-content>aynaud phenomenon, usually as the earliest manifestation of disease. In addition to pain and functional impairment, <jats:styled-content style=\"fixed-case\">R<\/jats:styled-content>aynaud phenomenon can produce tissue ischaemia resulting in digital ulceration and gangrene. Current treatments have been only moderately successful in reducing the frequency and severity of <jats:styled-content style=\"fixed-case\">R<\/jats:styled-content>aynaud phenomenon in patients with systemic sclerosis. 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