[Clinical and capillaroscopic study of Raynaud's phenomenon in retired patients previously exposed to vinyl chloride monomer].

Unlabelled: The course of Raynaud's phenomenon (RP) after the end of exposure to vinyl chloride monomer (VCM) is not really well known. Fourty four subjects were studied, from 128 retired patients who were exposed to VCM (end of the exposure since 8 years at least): 17 complained of "white finger crisis", and 27 voluntary retired subject without complaints (table II). The aims of this study were to specify capillaroscopic and clinical characteristics of these complaints to define and to assess the role of VCM. Each patient underwent an interview, a clinical examination and a nailfold capillary microscopy examination.

Results: 1) The 17 pensioners with complaints suffered from RP. But for 12 of them the onset of RP was in the exposed period (table I). From the clinical interview, the clinical and capillaroscopic examinations in these 12 RP may be attributed to the past exposure to VCM. 2) The majority of 44 subjects showed no capillary abnormalities. For 3 subjects changes consisted in isolated capillary dystrophia (1 with PR, 2 without PR) and for 2 subjects changes consisted in isolated neocapillaries (1 with PR, 1 without PR). The other microvascular changes were not specific (table III). In conclusion, RP secondary to VCM can still persist after the end of exposure in patients who suffered from RP during the exposure, 9% of the population (12/128). In view of discordance of clinical symptoms and capillaroscopic abnormalities, capillary lesions did not appear as the main physiopathologic factor in the persistence of the PR secondary to CVM.