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Official Journal of the Italian Society of Dermatology and Sexually Transmitted Diseases
Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,014
Online ISSN 1827-1820
Richetta A., Giustini S., Faiola R., Divona L., Carlesimo M., Calvieri S.
Università degli Studi «La Sapienza» - Roma Istituto di Clinica Dermatologica
Digital necrosis can occur either as a clinical manifestation during coagulation anomalies, autoimmune disorders, infectious diseases, tumors, hypereosinophilic syndrome, or as a complication during chemotherapy, Raynaud’s phenomenon, associated with these disorders, in 30% of cases, can be responsible of digital necrosis. A case of a patient affected by digital necrosis on the second finger of the right hand, associated with Raynaud’s phenomenon is presented. Blood examinations revealed hypereosinophilia, an inversion of the CD4/CD8 rate and an altered NKCA (natural killer cell activity). Cryoglobulins assay was negative. ANA, ENA (Anti-Sm, Anti-Rnp, Anti-SSa, anti-SSb, anti-Scl70) and HIV, HBsAg, HCV tests were negative. Arteriography of the upper limbs vessels showed agenesis of the right ulnar artery and a right radial arteritis. The median inferior tract of the left radial and ulnar arteries affected by arteritis, showed multiple obstructions too. Therefore bilateral obstruction of the superficial palmar arches and interdigital arteries were present. The patient underwent a vasodilatative, antiaggregant and hyperbaric therapy. The authors describe this case for the peculiar clinical features and unclear pathogenesis.