Digital ulcer generally reflects the presence of focal ischemia related to a microangiopathy. Etiologies are dominated by connectivites in women and by diffuse arteriopathies such as Leo-Buerger disease in men, as well as emboligenic heart disease. This article describes the case of a 46-year-old chronic hemodialysis female patient with nephroangiosclerosis, who presented a progressive onset of intermittent cyanosis of the fingertips and toes. The symptomatology was worsened by the evolution toward necrosis at the amputation stage. Etiological workup was in favor of multiple myeloma, requiring the initiation of chemotherapy.