Raynaud's phenomenon, digital ulcers and critical digital ischaemia
Raynaud's phenomenon, digital ulcers and critical digital ischaemia
Raynaud's phenomenon, digital ulcers and critical digital ischaemia
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1.<br />
Management of Raynaud’s Phenomenon<br />
Establish diagnosis <strong>and</strong> identify any<br />
underlying cause amenable to treatment<br />
No underlying cause amenable to treatment<br />
Treat underlying cause e.g. cryoglobulinaemia<br />
2.<br />
General/lifestyle measures:<br />
Patient education<br />
- Avoid cold, keep warm<br />
- Stop smoking<br />
(Complementary therapies)<br />
Ineffective<br />
3.<br />
Drug therapy: first line<br />
4.<br />
CCB, ARB, SSRI, alpha blockers, ACE<br />
inhibitors, topical nitrates<br />
+<br />
Antiplatelet <strong>and</strong> /or statin<br />
therapy<br />
Effective<br />
Ineffective oral therapies/refractory disease<br />
5.<br />
Drug therapy: refractory<br />
IV prostanoid<br />
Effective<br />
6.<br />
Ineffective<br />
PDE5 inhibitor<br />
Effective<br />
Progression to <strong>digital</strong> ulceration <strong>and</strong>/or <strong>critical</strong> <strong>ischaemia</strong>
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