title: [Digital necrosis in hand by uncommon mechanism].
abstract: A 43-year-old, non-smoking man presented with acute ischemic lesions of his left hand. He had been taking beta-blockers for his arterial hypertension. The day before the occurrence of these acute lesions, he self medicated with a drug containing ergotamine and caffeine because of a headache. About one hour after mild trauma to the hand, he noticed intense cyanosis accompanied by severe pain in the fingers that progressed to digital necrosis. Hematological tests, hand radiography, echo Doppler, and nailfold videocapillaroscopy were performed. Digital necrosis owing to an unusual combination of ischemic mechanisms is assumed.
authors.affiliation: Centro de Referencia en Raynaud y Colagenopatías, Rosario, Santa Fe, Aegentina. . leroux_mb@hotmail.com
authors.forename: Maria Bibiana
authors.initials: MB
authors.lastname: Leroux
authors.forename: Celina
authors.initials: C
authors.lastname: Lashak
authors.forename: Martin
authors.initials: M
authors.lastname: Mazzurco
mesh_terms: D058671:Adrenergic beta-1 Receptor Antagonists / Q000009:adverse effects / Q000627:therapeutic use; D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000009:adverse effects / Q000627:therapeutic use; D017298:Bisoprolol / Q000009:adverse effects / Q000627:therapeutic use; D002110:Caffeine / Q000009:adverse effects / Q000627:therapeutic use; D000697:Central Nervous System Stimulants / Q000009:adverse effects / Q000627:therapeutic use; D004359:Drug Therapy, Combination / Q000009:adverse effects*; D004878:Ergotamine / Q000009:adverse effects / Q000627:therapeutic use; D005385:Fingers / Q000473:pathology*; D006230:Hand Injuries / Q000150:complications*; D006261:Headache / Q000188:drug therapy; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D007511:Ischemia / Q000139:chemically induced* / Q000150:complications; D008297:Male; D009336:Necrosis / Q000209:etiology; D012651:Self Medication; D014949:Wounds, Nonpenetrating / Q000150:complications
chemical_list: D058671:Adrenergic beta-1 Receptor Antagonists; D018712:Analgesics, Non-Narcotic; D000697:Central Nervous System Stimulants; D002110:Caffeine; D004878:Ergotamine; D017298:Bisoprolol