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A 48-year-old diabetic woman presented with 2-day history of fever and skin discolouration over hand. On admission, her vital parameters were stable and systemic examination unremarkable. Cutaneous examination revealed well-defined dusky ecchymotic patches with tender indurated margins, haemorrhagic bulla, focal gangrenous necrosis and ulceration involving the right hand (figure 1). Routine laboratory investigations including coagulation profile, protein C and S, antithrombin III and fibrin degradation products were within normal range. Blood …
Contributors AS contributed to initial patient assessment and follow-up, conception, drafting of manuscript and final approval of manuscript. DBB and SC contributed to conception, critical revision of content and final approval of manuscript. All authors are in agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Competing interests None declared.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; internally peer reviewed.
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