Case presentation A 75-year-old male developed acral wet necroses on his fingers, toes, and wet necroses in the sacral region, 25 days after confirmation of COVID-19, interpreted as a consequence of COVID-19 (Figure 1a). Medical history Systemic sclerosis (diffuse type), anti-RNA polymerase enzyme III positive Heart failure, atrial fibrillation End-stage renal disease Disseminated prostate cancer Treatment Immunosuppressants and anticoagulants were administered. Two days after starting the above-mentioned medications, interdigital nerve cord injection – botulinum toxin A 100 U, was administered to all the fingers on phalanx II-V and in palma manus bilaterally (Figure 1c).
There was a remarkable improvement on the fingertips and the inflammation line 3 days after the injection was given (Figures 1a & 1b). Subjective pain relief also was noticed within a few days following the injection.…
