Rheumatology Question 13 Instructor

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.

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