Hallazgos capilaroscópicos y características clínicas en pacientes con fenómeno de Raynaud primario y secundario / Capillaroscopic findings and clinical characteristics in patients with primary and secondary Raynaud's phenomenon

Objetivos: describir hallazgos de videocapilaroscopía (VCP) en pacientes con fenómeno de Raynaud primario (FRP) y secundario (FRS); comparar características demográficas y clínicas entre ambos. Materiales y métodos: estudio observacional, analítico, transversal. Se documentaron edad, ocupación, tiempo de evolución del FR, enfermedad del tejido conectivo (ETC) y características capilaroscópicas. Las VCP se informaron como patrón normal, inespecífico o SD temprano, activo y tardío. Se realizó estadística descriptiva. Para variables categóricas se empleó Chi² o test exacto de Fisher; para variables continuas, t test o Man Whitney, considerando estadísticamente significativa p<0,05. Resultados: se realizaron 290 VCP. En pacientes con FRP (n:122), 18% (n:23) fue normal y 81% (n:99) con patrón inespecífico. En pacientes con FRS (n:168), 8% fue normal, 42% con patrón inespecífico y 51% con patrón SD (25% temprano, 44% activo, 31% tardío). Se hallaron diferencias estadísticamente significativas: tiempo de evolución de FR en meses (12 vs 36, p<0,01), VCP normal (18,85% vs 7,4%, p<0,01), patrón inespecífico (81,14% vs 41%, p<0,01) en pacientes con FRP vs. FRS. Conclusiones: en pacientes con FRS predominó el patrón SD, mientras que en aquellos con FRP fue superior el patrón normal e inespecífico. El FRS se asoció a mayor tiempo de evolución.

Objectives: to describe videocapillaroscopy (VCP) findings in patients with primary Raynaud's phenomenon (PRP) and secondary (SRP); compare demographic and clinical characteristics between both. Materials and methods: observational, analytical, cross-sectional study. Age, occupation, evolution time of RP, connective tissue disease (CTD) and capillaroscopic characteristics were documented. The VCP were reported as normal, nonspecific or early, active, and late SD pattern. Descriptive statistics were performed. Chi² or Fisher's exact test were used for categorical variables; for continuous variables t test or Man Whitney, considering statistically significant p<0.05. Results: 290 VCP were performed. In patients with PRP (n:122), 18% (n:23) were normal and 81% (n:99) non-specific. In patients with SRP (n:168), 8% were normal, 42% non-specific and 51% with SD pattern (25% early, 44% active, 31% late). We found statistically significant differences: time of evolution of RP in months (12 vs. 36, p<0.01), normal VCP (18.85% vs 7.4%, p<0.01), non-specific pattern (81.14% vs 41%, p<0.01) in patients with PRP vs SRP. Conclusions: in patients with FRS predominated the SD pattern, while in those with FRP the normal and nonspecific pattern was superior. FRS was associated with a longer evolution time.

Relationship between the Attacks of Raynaud's Phenomenon and Air Temperature. A Long-term observation on the subjects with Raynaud's phenomenon in a mountain area and in a plain area / 日本温泉気候物理医学会雑誌

The attack of Raynaud's phenomenon (RP) is characterized by finger blanching in response to cold or emotional stimuli.<br>To clarify the relationship between the attack of RP and air temperature, certain inhabitants of mountain village “T” (N₁=23) who had primary RP (PRP) were observed every day from August 20, 1990 to May 31, 1991 and those in town “K” (N₂=20) were observed from November 1, 1990 to May 31, 1991. One hundred and sixty-seven attacks of RP among 6 subjects in T Village and 89 attacks among 8 subjects in K Town were observed.<br>In T Village, the frequency of attacks was high in the morning, and the minimum and mean air temperatures in the days when some of the subjects had attacks (“attack days”) were significantly lower than those in the days when there was no attack on any subject (“non-attack days”). In K Town the frequency of attacks was high both in the morning and in the evening. In addition, the, mean and maximum air temperatures on the “attack days” were significantly lower than those on the “non-attack days.” The threshold temperature to cause RP attacks differed from one subject to another (5.2 to 17.6°C) in K Town during the period from November through February. The minimum air temperature which caused an attack of RP on any subject in T Village from August 20 to December 31 was 17.8°C.<br>These results suggest that cooling of the whole body in daily life promotes the onset of attacks of RP. When the minimum air temperature becomes lower than 18°C from autumn to winter, the whole body must be protected against cold to prevent the onset of RP.