Images in Clinical Medicine
A Medical Mystery — Gangrene and Cutaneous Nodules
N Engl J Med 2006; 354:1515April 6, 2006
- Article
A 62-year-old man presented with a one-month history of digital gangrene affecting the right hand (Panel A). One digit had been partially amputated 20 years before, after an accident. The skin of his arms and legs had reddish-blue, mottled discolorations in a net-like pattern (Panel B) with palpable cutaneous nodules. Otherwise, the physical examination was unrevealing. The patient did not smoke cigarettes. Urinalysis and a complete blood count were normal. Laboratory testing revealed normal renal function and liver function. Tests for antineutrophil cytoplasmic autoantibody, hepatitis B virus, and hepatitis C virus were negative. A biopsy specimen of a nodule is shown in Panel C (hematoxylin and eosin). There were no abnormalities on computed tomography of the head, neck, and thorax or on the echocardiogram. What is the diagnosis?
Stefan Schanz, M.D.
Anja Ulmer, M.D.
University of Tuebingen, D-72076 Tuebingen, Germany- Citing Articles (1)
Citing Articles
1
Schanz, Stefan, Ulmer, Anja, . (2006) Medical Mystery: Gangrene and Cutaneous Nodules — The Answer. New England Journal of Medicine 354:22, 2393-2394
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