Evidence-based management of Raynaud’s phenomenon

Abstract

Raynaud's phenomenon (RP) is relevant to the rheumatologist because it may signify an underlying connective tissue disease and also because it can be very challenging to treat, especially when it has progressed to digital ulceration or critical ischaemia. This review article discusses diagnosis (does this patient have an underlying connective tissue disease?), including the role for nailfold capillaroscopy, and treatment. Management of 'uncomplicated' RP is first described and then treatment of RP complicated by progression to digital ulceration or critical ischaemia, highlighting recent advances (including phosphodiesterase type 5 inhibition, and endothelin 1 receptor antagonism) and the evidence base underpinning these. Possible future therapies are briefly discussed.

Raynaud's phenomenon as a presenting manifestation of ovarian cancer: A case report

“…This could be explained by the heterogeneity of possible underlying pathomechanisms of the phenomenon 7,17 . However, as for other neoplastic syndromes, various reports have demonstrated that occasionally, treatment of the malignancy can alleviate PRNP 18,19 . These reports corroborate with our patient's course, as 4 cycles of chemotherapy led to regression of the RP.…”

COVID-19-Induced Vestibular Neuritis, Hemi-Facial Spasms and Raynaud's Phenomenon: A Case Report

“…It usually responds well with general measures like smoking cessation, avoidance of cold exposure, repeated trauma, and vasoconstricting drugs. The few patients who do not respond to general measures require pharmacological treatment that includes a calcium channel blocker, losartan, and an angiotensin II receptor blocker [ 20 ]. The RP manifestations in our patient improved with simple conservative measures and did not require any pharmacological management as such.…”

A Real-World Experience of Mycophenolate Mofetil for Systemic Sclerosis: A Retrospective Multicenter Observational Study

“…[ 30 ] Although inflammatory cascade and ROS play a role in the pathogenesis of SSc,[ 31 ] structural and functional abnormalities of microvasculature are the main drivers for digital ischemia. [ 32 ] Therefore, immunosuppressants including MMF could be ineffective to obliterative vasculopathy in patients with SSc.…”