Cutaneous Microembolism of Fingers and Toes

Authors

  • Uwe Wollina Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Friedrichstrasse 41, 01067 Dresden
  • André Koch Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Friedrichstrasse 41, 01067 Dresden
  • Birgit Heinig Center for Physical Therapy and Rehabilitative Medicine, Städtisches Klinikum Dresden, Dresden
  • Georgi Tchernev Department of Dermatology, Venereology and Dermatologic Surgery, Medical Institute of Ministry of Interior; Onkoderma Policlinic for Dermatology and Dermatologic Surgery, Sofia
  • Torello Lotti Università Degli Studi "G. Marconi”, Rome

DOI:

https://doi.org/10.3889/oamjms.2018.025

Keywords:

Microembolism, Skin, Infections, Tumors, Metabolic disorders, Autoimmune disorders, Coagulation disorders, Physical factors, Vascular occlusive disease

Abstract

A macro vascular embolism is a well-known emergency. In contrast, cutaneous microembolism is a lesser known symptom. However, cutaneous microembolism of fingers and toes is a red flag symptom for vascular emergencies. The underlying cause may involve infectious, immunological, metabolic and physical disorders, coagulation disorders and malignancies. Early recognition can help to live safe.

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References

Leclère FM, Mordon S, Schoofs M. Acute digital ischemia: a neglected microsurgical emergency. Report of 17 patients and literature review. Microsurgery. 2010; 30(3):207-13. PMid:19967763

Musani MH, Musani MA, Verardi MA. Venous gangrene a rare but dreadful complication of deep venous thrombosis. Clin Appl Thromb Hemost. 2011; 17(6):E1-3. https://doi.org/10.1177/1076029610376629 PMid:20699257

Shahi N, Nair R. Paradoxical digital ischaemia. BMJ Case Rep. 2010;2010.

Zhang XT, Jin WW, Ma XH, Yu HF, Tang XH. Ecthyma gangrenosum in a 3-month-old, previously healthy infant: A case report. Medicine (Baltimore). 2017; 96(10):e6244. https://doi.org/10.1097/MD.0000000000006244 PMid:28272221 PMCid:PMC5348169

Loricera J, Blanco R, Hernández JL, Calvo-Río V, Ortiz-Sanjuán F, Mata C, Rueda-Gotor J, Ãlvarez L, González-Vela MC, González-López MA, Armesto S, Pina T, González-Gay MA. Cutaneous vasculitis associated with severe bacterial infections. A study of 27 patients from a series of 766 cutaneous vasculitis. Clin Exp Rheumatol. 2015; 33(2 Suppl 89):S-36-43.

Delgado-Jiménez Y, Fraga J, Requena C, Requena L, Aragües M, Fernandez Herrera J, Garcia Diez A. Acute bacterial septic vasculopathy. Int J Dermatol. 2013; 52(9):1071-80. https://doi.org/10.1111/j.1365-4632.2012.05468.x PMid:23231414

Shiber JR, Wooten SL. Images in emergency medicine. Digital septic emboli. Ann Emerg Med. 2007; 50(6):740-748. https://doi.org/10.1016/j.annemergmed.2007.04.020 PMid:18023758

Thimmesch M, Bodart E, Gavage P, Misson JP, Frère J. [Two case reports of meningococcemia. Review of the literature on chronic meningococcemia]. Arch Pediatr. 2016; 23(6):595-8. https://doi.org/10.1016/j.arcped.2016.03.011 PMid:27133366

de Kleijn ED, de Groot R, Hack CE, Mulder PG, Engl W, Moritz B, Joosten KF, Hazelzet JA. Activation of protein C following infusion of protein C concentrate in children with severe meningococcal sepsis and purpura fulminans: a randomized, double-blinded, placebo-controlled, dose-finding study. Crit Care Med. 2003; 31(6):1839-47. https://doi.org/10.1097/01.CCM.0000072121.61120.D8 PMid:12794428

Abenza-Abildua MJ, Fuentes-Gimeno B, Morales-Bastos C, Aguilar-Amat MJ, Martinez-Sanchez P, Diez-Tejedor E. Stroke due to septic embolism resulting from Aspergillus aortitis in an immunocompetent patient. J Neurol Sci. 2009; 284(1-2):209-10. https://doi.org/10.1016/j.jns.2009.04.037 PMid:19442990

Siddiqui MA, Khan MA, Ahmed SS, Anwar KS, Akhtaruzzaman SM, Salam MA. Recent outbreak of cutaneous anthrax in Bangladesh: clinico-demographic profile and treatment outcome of cases attended at Rajshahi Medical College Hospital. BMC Res Notes. 2012; 5:464. https://doi.org/10.1186/1756-0500-5-464 PMid:22929128 PMCid:PMC3493280

Patassi AA, Saka B, Landoh DE, Agbenoko K, Tamekloe T, Salmon-Ceron D. Detection and management of the first human anthrax outbreak in Togo. Trop Doct. 2016; 46(3):129-34. https://doi.org/10.1177/0049475515622331 PMid:26672006

Cardaioli P, Rigatelli G, Arboit M, Giordan M, Roncon L. Treatment of cholesterol crystal embolisation syndrome with filter-assisted stenting. J Cardiovasc Med (Hagerstown). 2007; 8(11):953-5. https://doi.org/10.2459/JCM.0b013e32801452ac PMid:17906485

Rodríguez Bandera AI, Stewart NC, Uribe P, Minocha R, Choi JY. Cutaneous embolism of an atrial myxoma. Australas J Dermatol. 2015; 56(3):218-20. https://doi.org/10.1111/ajd.12301 PMid:25810316

Carmona-Bayonas A, Sánchez-Cánovas M, Plasencia JM, Custodio A, Martínez de Castro E, Virizuela JA, Ayala de la Pe-a F, Jiménez-Fonseca P. Key points to optimizing management and research on cancer-associated thrombosis. Clin Transl Oncol. 2017. https://doi.org/10.1007/s12094-017-1692-4

Stelzner C, Zimmermann F, Schellong SM. Fingernekrose bei einem Patienten mit Atherosklerose – auch paraneoplastisch bedingt? Dtsch Med Wochenschr. 2012; 137(15):780-4. https://doi.org/10.1055/s-0032-1304914 PMid:22492412

Walden R, Adar R, Mozes M. Gangrene of toes with normal peripheral pulses. Ann Surg. 1977; 185(3):269-72. https://doi.org/10.1097/00000658-197703000-00003 PMid:843122 PMCid:PMC1396603

Marchioli R, Finazzi G, Specchia G, Cacciola R, Cavazzina R, Cilloni D, De Stefano V, Elli E, Iurlo A, Latagliata R, Lunghi F, Lunghi M, Marfisi RM, Musto P, Masciulli A, Musolino C, Cascavilla N, Quarta G, Randi ML, Rapezzi D, Ruggeri M, Rumi E, Scortechini AR, Santini S, Scarano M, Siragusa S, Spadea A, Tieghi A, Angelucci E, Visani G, Vannucchi AM, Barbui T; CYTO-PV Collaborative Group. Cardiovascular events and intensity of treatment in polycythemia vera. N Engl J Med. 2013; 368(1):22-33. https://doi.org/10.1056/NEJMoa1208500 PMid:23216616

Banala SR, Yeung SJ, Rice TW, Reyes-Gibby CC, Wu CC, Todd KH, Peacock WF, Alagappan K. Discharge or admit? Emergency department management of incidental pulmonary embolism in patients with cancer: a retrospective study. Int J Emerg Med. 2017; 10(1):19. https://doi.org/10.1186/s12245-017-0144-9 PMid:28589462 PMCid:PMC5461224

Rodgers JA, Engles DR, Idler RS. Resistance to activated protein C and digital thrombosis. Iowa Orthop J. 2002;22:90-3. PMid:12180620 PMCid:PMC1888383

Dorweiler B, Neufang A, Kasper-Koenig W, Schinzel H, Schmiedt W, Oelert H. Arterial embolism to the upper extremity in a patient with factor V Leiden mutation (APC resistance) - a case report and review of the literature. Angiology. 2003; 54(1):125-30. https://doi.org/10.1177/000331970305400117 PMid:12593506

Marie I, Hervé F, Primard E, Cailleux N, Levesque H. Long-term follow-up of hypothenar hammer syndrome: a series of 47 patients. Medicine (Baltimore). 2007; 86(6):334-43. https://doi.org/10.1097/MD.0b013e31815c95d3 PMid:18004178

Klitscher D, Müller LP, Rudig L, Simiantonaki N, Arnold G, Rommens PM. Das "progrediente" Hypothenar-Hammer-Syndrom. Chirurg. 2005; 76(12):1175-80. https://doi.org/10.1007/s00104-005-1087-x PMid:16208509

Schmidt WA, Wernicke D, Kiefer E, Gromnica-Ihle E. Colour duplex sonography of finger arteries in vasculitis and in systemic sclerosis. Ann Rheum Dis. 2006; 65(2):265-7. https://doi.org/10.1136/ard.2005.039149 PMid:16410532 PMCid:PMC1798001

Wollina U, Verma SB. Acute digital gangrene in a newborn. Arch Dermatol. 2007; 143(1):121-2. https://doi.org/10.1001/archderm.143.1.121 PMid:17224560

Aringer M, Erler A. Recent advances in managing systemic sclerosis. F1000Res. 2017; 6:88. https://doi.org/10.12688/f1000research.10022.1 PMid:28184295 PMCid:PMC5288672

Daumas A, Magalon J, Jouve E, Truillet R, Casanova D, Giraudo L, Veran J, Benyamine A, Dignat-George F, Magalon G, Sabatier F, Granel B. Long-term follow-up after autologous adipose-derived stromal vascular fraction injection into fingers in systemic sclerosis patients. Curr Res Transl Med. 2017; 65(1):40-43. https://doi.org/10.1016/j.retram.2016.10.006 PMid:28340695

Bustamante J, Bhimji S. Antiphospholipid syndrome. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing, 2017.

Wollina U. Disorders Caused by Physical and Chemical Damage. In: Burgdorf WHC, Plewig G, Wolff HH, Landthaler M (Eds) Braun-Falco's Dermatology. 3rd edition. Springer Medizin Verlag: Heidelberg - New York, 2009: 598-616. https://doi.org/10.1007/978-3-540-29316-3_42

Li F, Liu J, Yang Z, Yan P, Liu Y. Effects of frostbite on some factors of blood coagulation system in rats under hypoxia. Space Med Med Eng (Beijing). 1996; 9(4):286-90.

Armstrong DG, Boulton AJM, Bus SA. Diabetic foot ulcers and their recurrence. N Engl J Med. 2017; 376(24):2367-2375. https://doi.org/10.1056/NEJMra1615439 PMid:28614678

Hughes M, Herrick AL. Digital ulcers in systemic sclerosis. Rheumatology (Oxford). 2017; 56(1):14-25. https://doi.org/10.1093/rheumatology/kew047 PMid:27094599

Małecki R, Kluz J, Przeździecka-Dołyk J, Adamiec R. The pathogenesis and diagnosis of thromboangiitis obliterans: Is it still a mystery? Adv Clin Exp Med. 2015; 24(6):1085-97. https://doi.org/10.17219/acem/33322 PMid:26771983

Wollina U. Update on calciphylaxis. Indian J Dermatol. 2013; 58(1):87-92. https://doi.org/10.4103/0019-5154.108026 PMid:23716795 PMCid:PMC3657275

Chia J, Eroglu FK, Özen S, Orhan D, Montealegre-Sanchez G, de Jesus AA, Goldbach-Mansky R, Cowen EW. Failure to thrive, interstitial lung disease, and progressive digital necrosis with onset in infancy. J Am Acad Dermatol. 2016; 74(1):186-9. https://doi.org/10.1016/j.jaad.2015.10.007 PMid:26584874 PMCid:PMC4691417

Published

2018-01-03

How to Cite

1.
Wollina U, Koch A, Heinig B, Tchernev G, Lotti T. Cutaneous Microembolism of Fingers and Toes. Open Access Maced J Med Sci [Internet]. 2018 Jan. 3 [cited 2021 Apr. 11];6(1):166-9. Available from: https://oamjms.eu/index.php/mjms/article/view/oamjms.2018.025

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