[Etiological profile of digital necrosis of the upper limbs: analysis of 25 cases].
OBJECTIVE
To investigate the etiologies of the upper limb digital necrosis based on a retrospective analysis of 25 cases.


METHODS
We retrospectively reviewed the medical records of patients treated for digital necrosis of the upper limb in four departments of internal medicine from January 1997 to December 2003.


RESULTS
There were 16 women and nine men, mean age 55 years. Eleven patients were smokers. Raynaud's phenomenon was noted in 12 cases. Connective tissue diseases were the most common cause (nine cases), all of them were women. The second cause was atherosclerosis (five cases) and Buerger's disease (five cases). In the other cases, the following diagnoses were found: vasculitis (three cases) and neoplasm (two cases). No cause could be identified in one female smoker.


CONCLUSIONS
Digital necrosis is a common symptom, revealing a vascular pathology. Its causes are diverse. In women, it first suggests a connective tissue disease whereas in men, a diffuse arteriopathy. The etiological diagnosis strategy should consider drug intake, anamnesis and Raynaud's phenomenon history. However, in all cases the etiology investigations should not delay the treatment in order to preserve functional prognosis.
Abdallah
M
M
Service de médecine interne, CHU Mongi Slim, Sidi Daoud, 2046 La Marsa, Tunisie. meyaabdelkefi@yahoo.fr
Hamzaoui
S
S
Larbi
T
T
Bouslama
K
K
Harmel
A
A
Ennafaa
M
M
Bahloul
Z
Z
Rokbani
L
L
Othmani
S
S
Ben Dridi
M
M
M'rad
S
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001161:Arteriosclerosis / Q000150:complications / Q000453:epidemiology; D001327:Autoimmune Diseases / Q000150:complications / Q000453:epidemiology; D003240:Connective Tissue Diseases / Q000150:complications / Q000453:epidemiology; D005260:Female; D005385:Fingers / Q000098:blood supply / Q000473:pathology*; D006801:Humans; D007511:Ischemia / Q000453:epidemiology / Q000209:etiology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D011928:Raynaud Disease / Q000150:complications / Q000453:epidemiology; D012189:Retrospective Studies; D012907:Smoking / Q000009:adverse effects; D013919:Thromboangiitis Obliterans / Q000150:complications / Q000453:epidemiology; D014416:Tunisia / Q000453:epidemiology