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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 . . . [Full Text of this Article] |
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