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A middle-aged shopkeeper, with type II diabetes mellitus presented with purple-black skin discolouration on both lower limbs, extending from toes till upper thighs (figure 1A,B, C). He complained of sudden bilateral lower extremity weakness 9 days back, after 2 days of which, he started having dusky discolouration on his toes that had progressed proximally. Sphincter function was preserved and there was no history of smoking, preceding claudication, trauma, new drug intake or intramuscular injections. The limbs were cold, and motor activity and sensations were impaired below the knee. Bilateral popliteal and tibial arteries were non-palpable.
Contributors AB and KV had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: AB and AG. Acquisition, analysis and interpretation of data: AB, AG, MSK and KV. Drafting of the manuscript: AB and AG. Critical revision of the manuscript for important intellectual content: MSK and KV. Statistical analysis: None. Administrative, technical, or material support: No. Study supervision: KV.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; internally peer reviewed.
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