Raynaud's phenomenon.
Vascular acrosyndromes constitute a common reason for physician visits. They are associated with connective tissue disease; for example, 90% of patients with scleroderma experience Raynaud's phenomenon. The rheumatologist must strive to establish the diagnosis, to identify a potential underlying cause, and to prescribe effective treatment when the symptoms are incapacitating. Raynaud's phenomenon is the acrosyndrome most commonly encountered by rheumatologists. The diagnosis of Raynaud's phenomenon rests on clinical grounds. Nailfold capillaroscopy and immunological tests are useful chiefly for determining the cause. Calcium-channel antagonists are the treatment of reference for Raynaud's phenomenon. Drugs introduced over the last few years for severe refractory forms include prostacyclin and its derivatives, endothelin receptor antagonists, and phosphodiesterase inhibitors. These drugs were developed as a result of new knowledge on the pathogenesis of Raynaud's phenomenon. Acrocyanosis, which is extremely common, and erythromelalgia are the other main vascular acrosyndromes.
Gayraud
Martine
M
Internal Medicine Department, Institut Mutualiste Motnsouris, 42 boulevard Jourdan, 75014 Paris, France. martine.gayraud@imm.fr
D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use; D057911:Angiotensin Receptor Antagonists; D003240:Connective Tissue Diseases / Q000150:complications; D004700:Endocrine System Diseases / Q000150:complications; D065128:Endothelin Receptor Antagonists; D005260:Female; D006401:Hematologic Agents / Q000627:therapeutic use; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000150:complications; D009566:Nitrates / Q000627:therapeutic use; D010726:Phosphodiesterase Inhibitors / Q000627:therapeutic use; D011453:Prostaglandins / Q000627:therapeutic use; D011928:Raynaud Disease / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D014652:Vascular Diseases / Q000150:complications; D014665:Vasodilator Agents / Q000627:therapeutic use; D014947:Wounds and Injuries / Q000150:complications
D000317:Adrenergic alpha-Antagonists; D057911:Angiotensin Receptor Antagonists; D065128:Endothelin Receptor Antagonists; D006401:Hematologic Agents; D009566:Nitrates; D010726:Phosphodiesterase Inhibitors; D011453:Prostaglandins; D017367:Selective Serotonin Reuptake Inhibitors; D014665:Vasodilator Agents