Raynaud’s Phenomenon and Ulcers

Raynaud’s phenomenon (RP) is a common condition which can occur either primary (idiopathic) or secondary to a wide range of conditions or drug therapies. In patients with systemic sclerosis (SSc), RP occurs within a spectrum of digital vascular disease, including digital ulceration and ischaemia. In this chapter, we present the background (clinical features, epidemiology, pathogenesis and differential diagnosis) and clinical assessment including an approach to investigations (in particular nailfold capillaroscopy and SSc-associated antibodies) which clinicians need to be aware of when assessing with patients with RP. The multifaceted contemporary approach to the management of RP is presented, including pharmacological strategies, with examples of drug doses and a number of treatment algorithms for digital vascular disease (including RP) which are intended to provide the clinician with a useful reference tool.