A 37-year-old woman was evaluated for extensive and progressive finger and toe necrosis. The patient has never smoked or abused alcohol. Her mother has rheumatoid arthritis. History of present ...

Case 1. Twenty hours before admission, a 19-year-old boy (C.H.M.C. 57–17–61) cut his right 5th finger while working with a lens-grinding machine.

Figure 1. Necrosis of toes, right foot. Figure 2. Left foot showing mottling, ischemia, and necrosis. Figure 3. Ulcerations and necrosis of fingers.