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Michelle T. Pelle, MD; O. Fred Miller III, MD

Arch Dermatol. 2002;138:1296-1298.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

REPORT OF A CASE

A 50-year-old man with a history of type 2 diabetes mellitus, coronary artery disease, peripheral vascular disease, and severe vascular calcification underwent placement of a brachial artery to antecubital vein arteriovenous fistula (AVF) in his left arm after the diagnosis of end-stage renal disease. He first experienced hand claudication and erythema of his left hand and digits 14 months after surgery. Pain and coldness of the left hand increased gradually over a 4-month period, and weakness was noted on examination. Vascular steal created by the fistula was suspected; however, the patient had a history of bilateral ulnar neuropathy, carpal tunnel syndrome, and generalized sensory axonal polyneuropathy. Ligation of the fistula was delayed because no other site was available for long-term angioaccess. The patient subsequently began continuous ambulatory peritoneal dialysis.

Ischemic ulcers developed at 18 months on the dorsal aspect of the . . . [Full Text of this Article]

DIAGNOSTIC CHALLENGE

COMMENT

From the Geisinger Medical Center, Danville, Pa.

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