Raynauds

Feature

  • White – blue – red [can swell sec. reactive hyperaemia] +- hyperhydrosis
  • From minutes to hours
  • 90% Primary Raynaud’s Phenomenon [Raynaud’s disease]
  • 10% Secondary Raynaud’s – in 40% SLE & 90% systemic sclerosis

Primary Raynauds

  • Starts teen & early 20s [consider secondary in > 30 or men]
  • Symmetrical
  • Mild discomfort only
  • No puffiness or tightness
  • No necrosis or gangrene
  • Normal ESR & Negative ANA +- Ro/La/Scl-70
  • Normal nail fold capillaries [+20 on opthalmoscope]
  • No feature of connective tissue disease [rash, joint pains, dryness, oral ulcers…]

Investigate [if atypical]

  • FBC, ESR, LFT, TFT, Total IgG, ANA, Urine, CXRAY, hand XRAY

Rx. [Severe cases]

  • Nifedipine [CI Pregnancy – breastfeeding – Within 1 month of MI – AS – HF – Peripheral oedema – hypotension – unstable angina] – [5 mg TDS, adjusted according to response to 20 mg 3 times daily]
  • Off license – http://www.raynauds.org.uk/raynauds/treatments

PIL

  • Information sheet: http://www.patient.co.uk/health/raynauds-phenomenon
  • Raynauds association: http://www.raynauds.org.uk/index.php