Symmetrical Peripheral Gangrene – A Rare Clinical Manifestation of Hodgkin’s Lymphoma

Abstract

Symmetrical peripheral gangrene (SPG) is a cutaneous manifestation of a wide array of infective and noninfective etiological factors and occurs due to hypoxemia, vasoconstriction, primary endothelial damage and/or decreased cardiac output. It is a devastating complication of underlying septicemia and disseminated intravascular coagulation (DIC) with a high mortality rate and commonly requiring amputation of the affected limb in those who survive. We here describe a case that presented with fever, cough, blackish discoloration of fingers and generalized lymphadenopathy. Investigation revealed anemia, leukocytosis, coagulopathy and positive D-dimer test. Fine-needle aspiration cytology (FNAC) showed evidence of Hodgkin’s lymphoma.