What features are suggestive that a patient has secondary Raynaud’s phenomenon rather than primary Raynaud’s phenomenon?
- Older age at onset (over age 40)
- ANA positivity (especially if anti-centromere anibodies are present)
- Dilated capillary loops at nail bases (These often lead to periungual erythema and can be seen more distinctly by examining nail bases through an ophthalmoscope set at 40 diopters.)
- Secondary damage, such as ischemic pits or autoamputation of digits.
- Presence of any other features of Raynaud’s-associated disease, such as lupus or scleroderma.
