PMC2782169_01
Gross photograph: finger tips show gangrenous changes.
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F1
Her fingertips were gangrenous (Fig. 1).
Lower extremity CT angiography; occlusions of right popliteal artery, right posterior tibial artery, right peroneal artery, left posterior tibial, left peroneal artery, left distal anterior tibial artery are seen.
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F2
It showed that the lower extremity arterial stenosis slightly progressed compared with previous study and upper extremity arteries below the wrist level had multiple stenosis (Fig. 2, 3).
Upper extremity CT angiography; multiple stenosis are seen in the upper extremity arteries below wrist level.
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F3
It showed that the lower extremity arterial stenosis slightly progressed compared with previous study and upper extremity arteries below the wrist level had multiple stenosis (Fig. 2, 3).
Skin biopsy: Immunohistochemistry show CD40L positive eosinophilic infiltration (x400).
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F4
Skin biopsy showed perivascular eosinophilic infiltration in the dermis and CD40 ligand (CD40L) positive eosinophilic infiltration (Fig. 4).
Serum TNF-alpha level compared with healthy controls and other hypereosinophilia without vasculitis.
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F5
The TNF-alpha was markedly increased more than that of several age-matched healthy persons and other hypereosinophilia patient without vasculitis (Fig. 5).