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January 1993

Painful Distal Erythema and Thrombocytosis

Author Affiliations

Ospedali Riuniti di Bergamo (Italy)

Arch Dermatol. 1993;129(1):107-108. doi:10.1001/archderm.1993.01680220121028

REPORT OF A CASE  A 60-year-old woman was admitted in May 1990 complaining of recurrent painful erythema on her left foot. The lesions had first appeared about 1 year before presentation. Initially, the erythema was limited to the big toe. During the subsequent months, the lesions extended to other toes on the left foot, which acquired a persistent bluish-red hue. Episodes of erythema were accompanied by sensation of burning and pain. Characteristically, the pain was triggered by warming and was relieved by cooling. For this reason, the woman used to sleep with her legs outside of the bed linens. The patient had a duodenal peptic ulcer 8 years before and had been taking maintenance doses of ranitidine (150 mg/d) for several months. Her history was otherwise uninformative. On physical examination, the big and the fourth toes of the left foot had a mottled blue-red discoloration and were slightly warmer than

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