This Journal feature begins with a case vignette highlightinga common clinical problem. Evidence supporting various strategiesis then presented, followed by a review of formal guidelines,when they exist. The article ends with the author's clinicalrecommendations.
A 37-year-old woman reports that her fingers turn blue whenthey are exposed to cold temperatures. She also has fatigue,arthralgias, and recurrent small, painful digital ulcers. Howshould she be evaluated and treated?
The Clinical Problem
In 1862, Maurice Raynaud recognized that some people who wereexposed to cold temperatures had transient digital ischemiathat he ascribed to an exaggerated response of the central . . . [Full Text of this Article]
Strategies and Evidence
Primary versus Secondary Raynaud's Phenomenon
Nonpharmacologic Therapy
Calcium-Channel Blockers
Other Agents
Areas of Uncertainty
Value of Other Vasodilators
Experimental Agents and Agents That Are Not Available in the United States
Sympathectomy
Acute Ischemic Crisis
Guidelines
Conclusions and Recommendations
Source Information
From the Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore.
Address reprint requests to Dr. Wigley at the Division of Rheumatology, Johns Hopkins University School of Medicine, 1830 E. Monument St., Suite 7300, Baltimore, MD 21205, or at lmurray3@jhmi.edu.
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