A 75-year-old man presented to the Emergency service with a syncope associated to low blood pressure. The most evident feature at the examination was an exuberant discoloration of the 2nd, 3rd, 4th and 5th fingers of both hands (Figure 1a) . Both radial pulses were present and there was no history of cardiovascular or autoimmune disease in the past, namely systemic lupus erythematous or scleroderma and no smoking habits.
Figure 1a: Exuberant discoloration of the 2nd, 3rd, 4th and 5th fingers of both hands
The patient underwent hand and finger warming with heated towels, with complete resolution of the event within seconds , despite noted the pigmentation asymmetry in the fingers comparing to the other areas of the hands. The patients ’ symptoms suggested the diagnosis of Raynaud’s phenomenon, characterized by finger pallor caused by vasoconstriction due to cold exposure. Considering the absence of relevant underlying medical disease, this case was considered a primary Raynaud’s phenomenon and the patient advised to keep the hands warm to prevent further episodes. The patient didn’t complain of similar occurrences after 6 month follow-up (Figure 1b).
Figure 1b: After 6 months follow-up
When categorized primary, it is a benign condition,  and the need of evaluation by a rheumatologist is debatable. A nailfold capillaroscopy is a suitable exam to perform in this type of situations, as it helps differentiating primary from secondary Raynaud’s. A basic autoimmune panel including ANA, SV and inflammatory markers may also be tested, if there is suspicion of underlying disease association .
There are no financial disclosures of mention concerning any author, as well as no conflict of interest.
Citation: Oliveira AL, Marques C (2019) Raynaud: A Phenomenon in the Emergency Room. Fam Med Med Sci Res 8:I105.
Received Date: May 28, 2019 / Accepted Date: May 29, 2019 / Published Date: Jun 03, 2019
Copyright: © 2019 Oliveira AL, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.