Unilateral finger tip ulcerations

Abstract

A 56-year-old white woman presented with a 4-month history of chronic-recurrent bullous and necrotic lesions involving the distal phalanges of the second and third fi ngers of her left hand. The same fi ngers were also affected by numbness, paresthesia, pain with night exacerbation, as well as loss of sensitive discrimination. Treatment with topical antibiotics and corticosteroids as well as systemic ibuprofen and prednisone had not helped. She had no other diseases, did not smoke and denied any trauma at work and at home.On physical examination, she had sharply demarcated necrotic areas of the fi ngertips and fl attened bullae of the palmar surface of the second and third fi ngers of the left hand ( Figure 1). We preformed electromyography that confi rmed our diagnosis. Figure 1 Sharply demarcated necrotic areas of the fingertips and flattened bullae of the palmar surface of the second and third fingers of the left hand.

Digital Ulcers as Presentation of Carpal Tunnel Syndrome

“…8,10,13 Hydrocolloid and hyaluronic acid dressings may improve the ulcers,7 but the most effective treatment is surgery. Ulcerations usually improve with the surgical treatment of CTS, 14,15 but osteolysis is permanent. 3,7 Surgical treatment consists in releasing carpal tunnel content by transection of the transverse carpal ligament.…”