Omar Viswanath1,2,3, Jacquelin Peck4, Jatinder S Gill5. 1. Valley Anesthesiology and Pain Consultants, Phoenix, Arizona, USA, viswanoy@gmail.com. 2. Department of Anesthesiology, University of Arizona College of Medicine-Phoenix, Phoenix, Arizona, USA, viswanoy@gmail.com. 3. Department of Anesthesiology, Creighton University School of Medicine, Omaha, Nebraska, USA, viswanoy@gmail.com. 4. Department of Anesthesiology, Mt. Sinai Medical Center of Florida, Miami Beach, Florida, USA. 5. Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
Abstract
OBJECTIVE: A 57-year-old female with a 33-year history of constant hand discoloration and paronychia had undergone multiple evaluations with a failure to find a diagnosis. She continues to undergo an evolving treatment regimen and diagnostic workup in an effort to find a long-eluded diagnosis. CLINICAL PRESENTATION: She began to develop superficial ulcerations over the proximal phalanx of her fingers, often pruritic and erythematous, with pain and edema. INTERVENTION: She has since been managed with nifedipine and sildenafil and intermittent stellate ganglion blocks. CONCLUSION: Despite still lacking a formal diagnosis, her constellation of symptoms is most likely the result of an atypical presentation of Raynaud's disease.
OBJECTIVE: A 57-year-old female with a 33-year history of constant hand discoloration and paronychia had undergone multiple evaluations with a failure to find a diagnosis. She continues to undergo an evolving treatment regimen and diagnostic workup in an effort to find a long-eluded diagnosis. CLINICAL PRESENTATION: She began to develop superficial ulcerations over the proximal phalanx of her fingers, often pruritic and erythematous, with pain and edema. INTERVENTION: She has since been managed with nifedipine and sildenafil and intermittent stellate ganglion blocks. CONCLUSION: Despite still lacking a formal diagnosis, her constellation of symptoms is most likely the result of an atypical presentation of Raynaud's disease.
Authors: Frank van den Hoogen; Dinesh Khanna; Jaap Fransen; Sindhu R Johnson; Murray Baron; Alan Tyndall; Marco Matucci-Cerinic; Raymond P Naden; Thomas A Medsger; Patricia E Carreira; Gabriela Riemekasten; Philip J Clements; Christopher P Denton; Oliver Distler; Yannick Allanore; Daniel E Furst; Armando Gabrielli; Maureen D Mayes; Jacob M van Laar; James R Seibold; Laszlo Czirjak; Virginia D Steen; Murat Inanc; Otylia Kowal-Bielecka; Ulf Müller-Ladner; Gabriele Valentini; Douglas J Veale; Madelon C Vonk; Ulrich A Walker; Lorinda Chung; David H Collier; Mary Ellen Csuka; Barri J Fessler; Serena Guiducci; Ariane Herrick; Vivien M Hsu; Sergio Jimenez; Bashar Kahaleh; Peter A Merkel; Stanislav Sierakowski; Richard M Silver; Robert W Simms; John Varga; Janet E Pope Journal: Arthritis Rheum Date: 2013-10-03
Authors: Benjamin Chaigne; Carlo Alberto Scirè; Rosaria Talarico; Tobias Alexander; Zahir Amoura; Tadej Avcin; Lorenzo Beretta; Andrea Doria; Aurelien Guffroy; Vera Guimarães; Éric Hachulla; Thomas Krieg; David Launay; Gemma Lepri; Pia Moinzadeh; Ulf Müller-Ladner; Simona Rednic; Ana Rodrigues; Sander W Tas; Ronald F van Vollenhoven; Ana Vieira; Stefano Bombardieri; João Eurico Fonseca; Ilaria Galetti; Matthias Schneider; Vanessa Smith; Maurizio Cutolo; Marta Mosca; Rebecca Fischer-Betz Journal: RMD Open Date: 2018-10-18