A 15-year-old man presents to the clinic accompanied by his mother for evaluation of “red hands.” He earned money last winter clearing sidewalks of snow and plans to do so again in the upcoming weeks. He reports developing red discoloration of his hands after returning home from the cold. The discoloration persisted for a few minutes until his hands were rewarmed. He denies weakness, paresthesia, pain, or skin lesions. He is otherwise healthy. At the time of consultation, inspection of his hands is unrevealing. Radial and ulnar pulses are 2+/2 bilaterally. The Allen test and reverse Allen test reveal return of color to the hands in 7 seconds bilaterally. His mother reports that she and her mother both have Raynaud phenomenon. The patient’s mother expresses concern that her son may have systemic lupus and she requests further testing.
When would be the most appropriate time to schedule a follow-up appointment?
A. 5 yearsAs needed. Although the patient does not have Raynaud phenomenon, he should be encouraged to follow up as needed because of his family history. Patients who have primary Raynaud phenomenon should have clinical follow-up for a minimum of 2 years after diagnosis.
Reference:
Wigley FM. Raynaud’s phenomenon. N Engl J Med. 2002;347:1001–1008.