Digital gangrene in a woman with scleroderma.

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Date: May 9, 2022
From: CMAJ: Canadian Medical Association Journal(Vol. 194, Issue 18)
Publisher: CMA Impact Inc.
Document Type: Clinical report
Length: 526 words
Lexile Measure: 1420L

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A 68-year-old woman presented to our clinic with intractable pain, pallor and dry gangrene at the tip of her right index finger (Figure 1A). She had a history of systemic sclerosis, including well-controlled Raynaud phenomenon, dysphagia, interstitial lung disease, complete heart block and progressive cardiomyopathy. She had no previous episode of critical digital ischemia (i.e., severe pain, digital ulceration or gangrene). Six weeks earlier, she had been admitted to the hospital with acute hypoxic respiratory failure and required multiple sampling via her right radial artery.

Angiography showed narrowing of the patient's right radial artery and occlusion of the right ulnar artery (Figure 1B). We attributed her digital gangrene to occlusion of the right ulnar artery from scleroderma macrovasculopathy and radial artery injury secondary to multiple punctures. Mittens, air-activated hand warmers, nifedipine,...

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Gale Document Number: GALE|A703277329