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THROMBOANGIITIS obliterans (Buerger's disease), limited primarily to the upper extremities, is rarely seen. Recently we have observed two patients with this disease of the upper extremity, neither of whom had clinical evidence of involvement of the lower extremities. In both patients painful ischemic ulcers of the finger tips developed. The lesions became infected and were treated as pyodermas until underlying vascular disease was recognized.
In typical cases of thromboangiitis obliterans, 40% of the patients suffer from arterial disease of the upper extremities in association with occlusive arterial disease of the lower extremities.1 It is unusual for the disease to develop in the hands clinically before there are symptoms referable to the legs.2 Constam reviewed the clinical findings of 94 patients with the disease and reported that in four of this group signs and symptoms of thromboangiitis obliterans of the upper extremities developed before the lower extremities were involved.3
FARBER EM, McLAIN MH. PRIMARY INVOLVEMENT OF THE UPPER EXTREMITIES IN THROMBOANGIITIS OBLITERANS. AMA Arch Derm Syphilol. 1951;64(3):352–355. doi:10.1001/archderm.1951.01570090099012
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