Raynaud Phenomenon — SCE Dermatology MCQ

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EasyConnective Tissue & VasculitisRaynaud PhenomenonSCE Dermatology

A 55-year-old man presents with Raynaud phenomenon secondary to systemic sclerosis. He has colour changes of white → blue → red on cold exposure. What is the first-line pharmacological treatment?

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Correct answer: C — Oral Nifedipine (modified release)

Oral Nifedipine (modified release, a dihydropyridine calcium channel blocker) is the first-line pharmacological treatment for Raynaud phenomenon in systemic sclerosis, reducing attack frequency and severity by approximately 33%. Second-line options include Amlodipine, Losartan, Sildenafil (PDE5 inhibitor), and topical GTN. IV Iloprost is reserved for severe refractory Raynaud or digital ulceration. Non-pharmacological measures (keeping warm, avoiding cold triggers, smoking cessation, avoiding vasoconstrictors) should be optimised first. The triphasic colour change (white → blue → red representing vasospasm → cyanosis → reactive hyperaemia) is classic.

Reference: BAD 2016 SSc Guidelines; EULAR 2017