Endocrine Abstracts

Introduction: Digital necrosis of the upper limbs is the final and often the only clinical manifestation of a of a distal arterial or microcirculatory pathology of the MS. The approach to The approach to this condition is very different, hence the particularity of our observation which highlights the severity of vascular lesions found in diabetic patients.

Observation: This is a 58 year old diabetic patient on mixtard 30: 16-00-08 ui; schizophrenia; on classic neuroleptic drugs; alcoholic and chronic smoker at Interrogation: Poorly monitored diabetes; Incoherent proposalsincoherent;an exacerbation of SPUPD;clinical examination: Patient conscious, cachectic, BMI 15 kg/m²; Radial pulse weakly perceived bilaterally; Neuropathic feet; Thyroid not paLpable;On workup: Nfs: normal; CRP: negative;Ionogram: normal; Liver workup: normal;AFP:8.19; CA19-9=1.1; total PSA =2; free PSA=0.338; serology: negative, echodopler of the MS: requested, the therapeutic management was based on:Optimization of his insulin regimen +local treatment of digital lesion.

Discussion and Conclusion: Digital necrosis and ulceration of the upper limb have various causes (vascular and metabolic, mechanical, toxic, etc.) and are often of polyfactorial origin. The positive diagnosis of a digital necrosis of the upper limbs is easy and represents only the visible face of a microcirculatory arterial pathology of the upper limb dominated by leo-burger type arteritis as in the case of our patient.