Raynaud phenomenon

To differentiate primary and secondary Raynaud, do nailfold capillaroscopy test

• put a drop of oil on patient's nailfold and look under microscope for any capillary changes.

Enlarged, dilated or absent nailfold capillaries in 2° causes such as scleroderma and other autoimmune diseases

Workup for suspected cases

Based on history and physical examination, workup for patients with suspected secondary RP may include:

• Complete blood count and metabolic panel
• Urinalysis
• Antinuclear antibody (ANA) and rheumatoid factor
• Erythrocyte sedimentation rate and complement levels (C3 and C4)

If the ANA screen is positive, specific antibodies (eg, antitopoisomerase-1 for systemic sclerosis) may be obtained.

For severe Raynaud phenomenon, use CCBs, esp. Nifedipine; for HTN, ACEIs are the drugs of choice

Antisynthetase syndrome

Antisynthetase syndrome is characterized by interstitial lung disease, myositis, Raynaud phenomenon, nonerosive inflammatory arthritis, constitutional findings such as low-grade fever, and mechanic's hands; anti-aminoacyl-tRNA synthetases antibodies, such as anti–Jo-1, are highly suggestive of the diagnosis.

Rheumatic fever

Rash may be described as "erythematous, serpiginous macular lesions with pale centers"%3B usually on the extremities