Clinical Reasoning: A Septuagenarian With Painless Ulceration on the Fingertip

Abstract

A 78-year-old non-diabetic non-smoker male presented with painless non-healing ulceration on the middle fingertip of the left hand. Similar episodes have occurred in the past involving the left middle and index fingers resulting in amputation of the tip of index finger. Diagnosis was arrived at by clinical reasoning and confirmed by additional investigations. The readers are presented with a rational step by step diagnostic paradigm in a very rare presentation of a common neurological disorder.