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
      • Topical nitrates
      • Phosphodiesterase 5 inhibitors
    • Surgical sympathetic blockade

Disposition

Patient with digital ischemia not responsive to oral or topical vasodilators may need anticoagulants, IV prostanoids, and sympathectomy

See Also

External Links

References