Peripheral arterial disease and digital gangrene: a rare presentation of diabetic hand syndrome

Abstract

Digital gangrene in upper limbs may be due to systemic sclerosis, trauma, connective tissue disorders, vasculitic disorders and various myeloproliferative disorders or as a part of tropical diabetes hand syndrome which follows trauma. Peripheral arterial disease in diabetics commonly involves lower limbs. The present case, 45-year-old diabetic, presented with dry gangrene in fingertips of both hands for last two weeks without any history of trauma or lower limb gangrene. On examination and workup of the patient was found to have bilateral upper limb arterio-occlusive disease involving ulnar vessels as a macrovascular complication of diabetes mellitus. This presentation of diabetic hand syndrome is very, very rare, hence being reported.

Keywords: Digital gangrene; Tropical diabetes hand syndrome; Upper limb.

[Table/Fig-1]:

Images showing dry gangrene involving bilateral hands on both the palmar and volar aspects

[Table/Fig-2]:

Image showing prayer sign along with gangrenous fingertips