International Journal of Clinical & Medical Images

Abstract A 30 year old female patient complained of pain and swelling of the small joints of the hands and legs. On enquiry, she informed that her skin over the tips of the fingers of both hands show episodes of colour changes (blanching, followed by cyanosis and then rubor; tri-phasic colour response). This is Raynaud’s phenomenon in a case of Systemic Lupus Erythematosus (SLE).

Brief Case History: DS, aged about 30 years, female patient reported to the Outpatients’ department of Peerless Hospitex Hospital in Kolkata, India in April 2015, complaining of pain and swelling of the joints mostly the small joints of the hands and legs. On enquiry, she informed that her skin over the tips of the fingers of both hands show episodes of colour changes (blanching, followed by cyanosis and then rubor; tri-phasic colour response). This colour changes typically occurred when she exposed her hands to cold as well as when she is emotionally upset (Image). She had fever, malaise, weakness and typical butterfly rashes in the face as well as reddish rashes all over the chest, some in the back and a few in the legs. Laboratory investigations revealed that ESR and C-reactive protein were high; ANA and DsDNA reactive. She was diagnosed to be suffering from Raynaud’s phenomenon in the context of Systemic Lupus Erythematosus (SLE). It affects more females than men. She was treated following standard guidelines as outpatient and after some time she left for her village.

Acknowledgment: We are grateful to the patient (name not disclosed) for allowing us to publish this photograph.