Case representation An 84-year-old male presented to a clinic with fever, malaise, and two-week history of discoloration and pain in his fingers and toes. The patient had no relevant history of smoking. Clinical Examination Body temperature: 37.8°C Blue-black discoloration in the distal part of the fingers (second through fifth) on the left hand (Fig.
1A) Several fingers on the right hand had dusky discoloration, with purpuric lesions on both hands and feet (Fig. 1A & 1B) Associated edema, but no sclerodactyly or telangiectasias was detected. Palpable radial and dorsalis pedis pulses on both sides of the hands Laboratory Tests Renal and liver function: Normal C-reactive protein level: 12.29 mg/deciliter Tests for antinuclear antibodies, antineutrophil cytoplasmic antibodies, antiphospholipid antibodies, hepatitis B virus, cryoglobulin, and cold agglutinin: Negative Blood cultures…
