Raynaud’s disease
Background
- Exaggerated vascular response to cold or emotional stress
Clinical Features
Raynaud Phenomenon
- Sharp demarcated color changes of the skin of the digits
- Pain, loss of sensation, and if recurrent ischemia may cause ulcers
Differential Diagnosis
- Primary (Raynaud disease or idiopathic Raynaud Phenomenon)
- Symptoms without an associated disorder
- Secondary (associated with another illness, i.e. SLE or Scleroderma)
Evaluation
- Assess for digital ischemia
- Consider evaluation for underlying disorder
Management
Improve quality of life and prevent ischemic tissue injury
- Patient education on trigger avoidance
- Severe cases/Ischemia
- Pharmacologic
- Oral vasodilators
- Nifedipine 30 to 180 mg/day
- Amlodipine 5 to 20 mg/day
- Topical nitrates
- Phosphodiesterase 5 inhibitors
- Oral vasodilators
- Surgical sympathetic blockade
- Pharmacologic
Disposition
Patient with digital ischemia not responsive to oral or topical vasodilators may need anticoagulants, IV prostanoids, and sympathectomy
See Also
External Links
References
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