ABSTRACT
Ninety percent of patients with scleroderma experience Raynaud’s phenomenon. It is also a component of the CREST (calcinosis, Raynaud’s phenomenon, oesophageal dysmotility, sclerodactyly, telangectasia) syndrome. These patients have small vessel occlusive disease that may lead to digital pitting or ulceration. Later obliterative endarteritis may occur and result in thrombosis, ischaemic changes in the skin of the digits and nails, superficial necrosis and finally gangrene. Sudden onset renal failure or necrosis of the bowel may result from endarteritis. Rheumatology specialists should be consulted prior to a surgical procedure in a patient suspected of CREST syndrome.
