PMC8022589_01
Skin Lesions of the Lower Limbs.. Bilateral lower limbs with diffuse islands of necrosis, superficial ulcerations and crusting spanning up to the lower knees. Left foot can be seen with the largest necrotic patch of approximately 8 x 6 cms over the medial plantar area.
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Multiple dark, necrotic, painless groups of ulcers and patches were present, with the largest lesion on the left foot and also spanning up the shins, as shown in Fig. 1, Fig. 2.
Computerized Tomography (CT) Scan of the Lungs.. Consolidative patterns with air bronchograms involving both lung fields with scattered areas of patchy ground-glass opacities. Suggestive of an organizing pneumonia.
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A high resolution CT-chest was done soon after that revealed an organizing bilateral pneumonia as shown in Fig. 3.
Left Plantar Foot Wound with Dry Gangrene.. Left plantar foot wound post-multiple debridements due to prior large necrotic patch, measuring approximately 8 x 6 cms. Tendons visible within wound with underlying deep tissue. Prominent development of dry gangrene in the large toe involving the toe base.
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Overtime the patient developed signs of ischemia of the left big toe which progressed to dry gangrene, as shown in Fig. 4.
Healing Left Foot Wound Post-Amputation of Large Toe.. Granulation tissue and slough can be seen within the wound with some serousanguinous exudate, dry wound edges and no signs of infection.
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Post-amputation and multiple debridements later, the patient's foot became cleared of infection and well-healed, as seen in Fig. 5.