Which statement best describes primary Raynaud's phenomenon?

• A. Well palpable peripheral pulses
• B. No starlike scars, finger ulcers or gangrene
• C. Normal capillaroscopic image
• D. All three

Answer: (C)

The key idea is distinguishing primary Raynaud’s phenomenon by looking for normal microvascular structure on nailfold capillaroscopy. In primary RP there’s no underlying connective-tissue disease, so the tiny vessels in the fingers don’t show structural changes. Nailfold capillaroscopy is therefore normal. In contrast, secondary RP from diseases like scleroderma or lupus tends to disrupt the capillaries, with dilated or looped vessels, capillary dropout, hemorrhages, or avascular areas. While having normal peripheral pulses and no finger ulcers or gangrene fits primary RP, the most definitive feature in questions like this is a normal capillaroscopic image.