What features distinguish primary from secondary Raynaud?

Primary RP: onset in young women, symmetric, no tissue ischemia, no ANA, normal nailfold capillaroscopy; Secondary RP (SSc, SLE, MCTD): asymmetric, digital ulcers possible, positive ANA/specific antibodies, abnormal nailfold capillaroscopy (giant capillaries, dropout).

What nailfold capillaroscopy findings predict SSc?

Giant capillaries (>50 μm), microhemorrhages, and capillary dropout (avascular areas) constitute the SSc capillaroscopy pattern; early SSc: rare giants + few hemorrhages; active: more giants + hemorrhages; late: dropout + disorganization.

What pharmacological treatment is used for Raynaud in SSc?

First-line: CCBs (nifedipine 30-60 mg/day); second-line: PDE-5 inhibitors (sildenafil 25-100 mg/day, tadalafil 20 mg/day); third-line: IV iloprost (prostacyclin) for severe attacks or digital ulcers; bosentan for prevention of new digital ulcers in SSc.

What is the digital ulcer prevention evidence for bosentan?

RAPIDS-1 and RAPIDS-2 trials: bosentan 125 mg BD reduces new digital ulcer formation by 48% in SSc patients with active ulcers or multiple prior ulcers; does not heal existing ulcers; approved in Europe for DU prevention in SSc.

What wound care is used for SSc digital ulcers?

Moist wound healing (Mepilex, hydrofiber dressings); debridement of necrotic tissue; infection treatment (flucloxacillin/co-amoxiclav for Staphylococcal); prostaglandin infusion (iloprost) for critically ischemic digits; surgical sympathectomy for refractory cases.

Raynaud Phenomenon Severity and Digital Ulcer Risk Assessment

Scores Raynaud phenomenon severity using RCS (Raynaud Condition Score), attack frequency, digital ulcer burden, and distinguishes primary from secondary RP with SSc digital vasculopathy management.

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Frequently Asked Questions

What features distinguish primary from secondary Raynaud?

What nailfold capillaroscopy findings predict SSc?

What pharmacological treatment is used for Raynaud in SSc?

What is the digital ulcer prevention evidence for bosentan?

What wound care is used for SSc digital ulcers?