A Puzzle in the Periphery

An 84-year-old man presents with Fever, malaise, and painful, blue-black discoloration of his fingers and toes. What is the underlying diagnosis?

Polyarteritis nodosa


An 84-year-old man presented with fever, malaise, and discoloration and pain in his fingers and toes ongoing for 2 weeks. He had no history of smoking. On physical examination, he was afebrile with blue-black discoloration on several fingers of his left hand and purpuric lesions on both hands and feet. He had palpable radial and dorsalis pedis pulses on both sides. What is the most likely diagnosis?

What is the most likely diagnosis?

Infection with Vibrio vulnificus
Polyarteritis nodosa
Necrotizing fasciitis
Herpetic whitlow
Arterial embolism

Digital ischemia, Fibrinoid Necrosis, Mononeuritis multiplex, Polyarteritis Nodosa, Vasculitis

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