Raynaud's Clinical Results

A 24 year old white male presented with a 6 month history of purple-cold left index finger which has progressively become worse until dry gangrene developed at the end of the finger as well as abscesses in 5 of the 10 fingertips underneath the nailbeds despite topical Neoteric diabetic skin lotion, hot paraffin wax, oral antibiotics and Cardizem 240mg daily without any improvement. RSD symptoms of pain radiating from each fingertip to just above each wrist also was present and unrelenting. Other contributing factors included 1 1/2 packs of Tobacco per day x 10 years and repeated cold and chemical exposure to his hands cleaning pools.
He presented with dry gangrene of his left index finger at the distal end. Purple-cool skin turgor was present.
He underwent Bilateral micro highly selective (T2 ganglion preserving) ETS having an immediate temperature rise from 27.5 to 32.0 degrees centigrade within minutes following the sympathectomy. Skin color immediately changed from pale-purple to light pink and resolution of his bilateral hand pain occurred as well. The left index finger pain from the dry gangrene even lessened immediately following ETS surgery.