Raynaud’s disease: Difference between revisions
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==Background== | ==Background== | ||
Exaggerated vascular response to cold or emotional stress | *Exaggerated vascular response to cold or emotional stress | ||
==Clinical Features== | ==Clinical Features== | ||
Sharp demarcated color changes of the skin of the digits | [[File:Raynaud's.png|thumb|Raynaud Phenomenon]] | ||
Pain, loss of sensation, and if recurrent ischemia may cause ulcers | *Sharp demarcated color changes of the skin of the digits | ||
*Pain, loss of sensation, and if recurrent ischemia may cause ulcers | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
Revision as of 22:54, 12 August 2018
Background
- Exaggerated vascular response to cold or emotional stress
Clinical Features
- 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