Raynaud's Phenomenon Flashcards
What is Raynaud’s phenomenon?
Vasospasms of the digits.
It is painful and is characterised by a sequence of coulour changes in response to a cold stimulus.
It can slo be precipitated by stress.
What colour changes are seen in Raynaud’s?
White -> Blue -> Red
What does white digits mean?
Inadequate blood flow
What does blue digits mean?
Venous stasis
What does red digits mean?
Re-warming hyperaemia
What is Raynaud’s syndrome?
It is the term used when the cause is idiopathic.
It is quite common in young women and may improve as they get older.
It may be familial
Treatment comprises of measures to keep digits warm and to avoid smoking.
When should you be thinking that RP might be due to a secondary cause?
If it develops over the age of 30.
What does RP with an abnormal nail-fold capillaries, or puffy fingers, or photosensitive rash suggest?
A rheumatic cause
What diseases is RP associated with?
Scleroderma
SLE
Dermatomyositis
Polymyositis
Sjögren’s syndrome
What physical causes is RP associated with?
Use of heavy vibrating tools
Cervical rib
Sticky blood .e.g cryoglobulinaemia
Drugs that can cause RP.
Beta blockers
Episodic pattern of Raynaud’s syndrome.
Last minutes an the pattern is symmetrical and bilateral.
Tissue necrosis is rare
Episodic pattern in RP of 2ndary cause.
May last for hours and pattern is often asymmetrical with only few digits affected.
Treatment of RP.
Keep digits warm and avoid smoking.
CCBs are first line such as nifedipine.
Phosphodiesterase-5 inhibitors and prostacyclins can be used as well.
Complications of RP.
Digital ulcers
Severe digital ischaemia
Infection.
