Digital ischaemia in people with secondary Raynaud phenomenon
Digital ischaemia, typically manifesting as digital ulceration, may occur due to secondary Raynaud phenomenon. When Raynaud phenomenon is secondary to systemic sclerosis, digital ulcers may result from the combined effects of severe Raynaud phenomenon and calcinosis. Ulcers occur over the tips of the digits, and also at sites of trauma, such as over the extensor surfaces of contracted digits.
Other causes of digital ischaemia include atherosclerotic disease with distal emboli, illicit intravenous drug use, hyperviscosity syndromes (often due to haematological malignancies; eg Waldenstrom macroglobulinaemia or myeloma), systemic vasculitis, thromboembolic disease and thromboangiitis obliterans.