Raynauds
phenomenon5% of patients develop autoimmune rheumatic disease.
Occupation
- Outdoor working
- Vibration
- Chemicals eg vinyl chloride
Drugs
beta-blockers
History
- Arthralgia
- Mouth ulcers
- Alopecia
- Photosensitivity
- Muscle weakness
- Skin rashes
- Dry eyes/mouth
- CVS/RS problems
Investigations
- FBC
- ESR
- U&E
- LFT & electropohoresis
- ANA
- Urinalysis
- CXR & Xray hands
- Nail fold capillaroscopy
Management
- Stop smoking
- Exposure to cold
- Vibrating tools
Drug treatment
- Nifedipine SR 20mg daily
- Diltiazem 60mg tds
- Nicardipine 20mg tds
- Felodipine 5-10mg daily
- Isradipine 1-2mg bd
- Maxepa 5 caps daily
- Epogam 4-6 caos bd
- Captopril 6.25-25mg daily