Abstract
G ANGRENE is usually associated with circulatory deficiencies and infectious processes or a combination of both. However, a group of cases has been observed by dermatologists in which all available studies have revealed no organic or infectious cause for the sudden death of circumscribed areas of skin. Trimble 1 presented a case of a circumscribed patch of gangrene of the thumb which was similar to these cases. Spillman 2 described the same phenomena in acute gangrene of the labium majus. Stopf 3 cited cases of spontaneous gangrene of the extremities in young adults in which causation was not revealed by thorough studies, and he ascribed the condition to constitutional weakness of the circulatory system. Touraine, 4 in the discussion of similar cases of acute idiopathic gangrene of the skin, postulated local infection, but unfortunately bacterial studies were not made. Vohwinkel 5 described a patient with trophoneurotic gangrene of the skin.
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