case_images: PMC6376526_01
case_images: Clinical photograph showing ray amputation of the second and third toes, with a poorly healed resultant wound.
case_images: 10.1177_1179547619828719-fig1.jpg
case_images: PMC6376526_01_10.1177_1179547619828719-fig1.jpg
case_images: fig1-1179547619828719
case_images: This ultimately resulted in a Ray amputation of the second and third toes due continued non-healing (Figure 1).
case_images: Clinical photographs showing the development (A) and progression (B) of digital ischaemia secondary to TAO.
case_images: 10.1177_1179547619828719-fig2.jpg
case_images: PMC6376526_01_10.1177_1179547619828719-fig2.jpg
case_images: fig2-1179547619828719
case_images: Unfortunately due to ongoing use of tobacco, symptoms recurred in the contralateral and dominant right hand affecting his index and middle finger tips (Figure 2A and B).
case_images: Histological appearance of biopsy tissue from the right index finger. (A) Epidermis with focal ulceration and a dermal acute on chronic inflammatory infiltrate surrounding adnexal structures; TAO is present with dermal fibrosis and background necrotic ulcer debris (40x magnification). (B) Fibrovascular tissue with chronic inflammation, lymphocytic arteritis and thrombosis (200x magnification).
case_images: 10.1177_1179547619828719-fig3.jpg
case_images: PMC6376526_01_10.1177_1179547619828719-fig3.jpg
case_images: fig3-1179547619828719
case_images: Histopathologic analysis showed evidence of chronic inflammation with lymphocytic arteritis and thrombosis, confirming a diagnosis of TAO (Figure 3).