Symmetrical peripheral gangrene and disseminated intravascular coagulation

Abstract

Symmetrical peripheral gangrene (SPG) is a rare syndrome associated with a multitude of underlying medical problems. We are adding three cases of SPG to the medical literature, all of which had disseminated intravascular coagulation (DIC). Each had an underlying illness that, to our knowledge, has not been previously associated with SPG: Hodgkin's lymphoma, Escherichia coli urinary tract infection with septicemia, and polymyalgia rheumatica. Review of the medical literature shows a high association between SPG and DIC. Symmetrical peripheral gangrene should therefore be considered a cutaneous marker of DIC. Early recognition and treatment of the underlying medical problem and DIC could be lifesaving.