Finger Gangrene Caused by Small Artery Occlusive Disease

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Abstract
About 1/3 of all patients presenting with localized finger gangrene develop the condition due to intrinsic occlusions of the small arteries of the hand and fingers caused by 1 of a variety of systemic diseases. Patients (35) were treated in the past 7 yr. A variety of diagnostic tests allowed the establishment of the diagnosis of connective tissue disease in 14 patients, hypersensitivity angiitis in 13 patients, arteriosclerosis in 5 patients and myeloid metaplasia, calciphylaxis and carcinoma in 1 patient each. Treatment with cold and tobacco avoidance, vasodilators and local debridement produced good results without amputation in 30 patients. Five patients required partial phalangeal amputation. Appropriate diagnostic tests apparently allow an accurate diagnosis in all patients. The natural history apparently is that of spontaneous improvement without major tissue loss. Surgical sympathectomy evidently plays no role in the treatment of these patients.