A Case of Digital Ulcers Associated with Essential Thrombocythemia

Abstract

A 56-year-old man had felt pain and numbness of the left foot for 6 months before visiting our hospital. A physical examination revealed livedoid lesions on his lower legs and feet, and cyanosis with ulcerations on his left toes. A histopathological examination showed vascular extension and hyperplasia in the upper dermis, and hypertrophy of the vascular wall in the middle dermis. Routine blood analysis showed a marked increase of platelet counts. The ensuing investigation was concluded with a diagnosis of essential thrombocythemia. A treatment using hydroxyurea led to improvement of the digital ulcers along with a decrease of platelet counts. We should note that livedo or cyanosis with ulcerations of the feet may be caused by essential thrombocythemia.