Occlusive digital artery disease in patients with Raynaud's phenomenon

In order to assess the relationship of occlusive digital artery disease to the presence or subsequent appearance of systemic illness in patients with Raynaud's phenomenon, the records of 147 patients with Raynaud's phenomenon, subdivided on the basis of quantitative finger plethysmographic results into those with and without occlusive digital artery disease, were reviewed. Patients with definite scleroderma were excluded from the study. Occlusive digital artery disease was detected in 62 percent of the 147 cases. A cause for Raynaud's phenomenon was found at initial evaluation in 34 percent of patients with occlusive digital artery disease and 24.9 percent of patients without it. Follow-up status was ascertained in 56 patients with no cause for Raynaud's phenomenon discovered at initial evaluation. During a follow-up period averaging five and a half years, systemic illness became apparent in 43.8 percent of those with occlusive digital artery disease and only 16.7 percent of those without it. Connective tissue diseases, primarily scleroderma, dominated in both categories, but carcinoma was also a problem and appeared only in patients with occlusive digital artery disease. The presence of occlusive digital artery disease in patients with Raynaud's phenomenon of no apparent cause warrants greater concern and closer follow-up for the development of cancer or connective tissue disease. Digital plethysmography for the detection of occlusive digital artery disease is an important part of the evaluation of patients with Raynaud's phenomenon.