case_images: PMC6968677_01
case_images: (a,b) The patient's right index and middle fingers on preoperative evaluation showing fingertip ulceration.
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case_images: On physical exam, there were exquisitely tender ulcerations at the tips of the right index and middle fingers, and left middle finger (Figure 1(a,b)).
case_images: Hyperplastic Pacinian corpuscles located adjacent to the radial neurovascular bundle of the right index finger.
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case_images: PMC6968677_01_ICRP_A_1698958_F0002_C.jpg
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case_images: Upon elevation of the skin flaps, numerous Pacinian corpuscles were noted amidst the volar subcutaneous tissue adjacent to the neurovascular bundles (Figure 2).
case_images: (a,b) Formal sympathectomies were performed on both the radial and ulnar neurovascular bundles with use of the operating microscope.
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case_images: Formal sympathectomies, using an adventitial stripping technique, were performed on both the radial and ulnar neurovascular bundles with the use of the operating microscope (Figure 3(a,b)).
case_images: (a,b) Evidence of healed digital ulcerations at 3-month follow-up.
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case_images: At his 3-month follow-up appointment he was noted to be pain-free and his digital ulcerations were completely healed (Figure 4(a,b)).
case_images: Cross-section of Pacinian corpuscle showing multi-lamellated connective tissue capsule at 2x (a), 4x (b), and 20x (c) magnification.
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case_images: PMC6968677_01_ICRP_A_1698958_F0005_C.jpg
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case_images: Tissue samples were sent to pathology for microscopic evaluation where the ultrastructures of the corpuscles were noted to be normal and not concerning for malignancy (Figure 5(a,b)).