Abstract
A 56-year-old man, a construction worker who quit smoking 4 years ago, has ischemic rest pain and cold intolerance in the ulnar 3 digits of his dominant right hand with a new ulceration at the tip of his right little finger (Fig. 1). These symptoms have progressed over several weeks and are worse when the weather is cold. Clinical examination shows a positive Allen test for ulnar artery occlusion. All 4 fingers show alternating color changes. The little finger ulcer is dry and shows no signs of infection.
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