Answer-Medical Challenge

The answer to the necrotic finger is #1 Thromboangiitis obliterans.This is a vaso-occlusive disease that involves small- and medium-sized vessels of the upper and lower extremities. It is strongly associated with tobacco use. An angiogram of this patient's right hand demonstrated multiple chronic occlusions of the digital branches of the small arteries that were unresponsive to IV vasodilators,