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Isolated Digital Necrosis in a Young Phototype VI Senegalese, Revealing Systemic Lupus Erythematosis (SLE)

Assane Diop, Mame Tene Ndiaye, Biram Seck, Abbaspour Valiollah, Maodo Ndiaye, Boubacar Ahi Diatta, Astou Diouf, Fatou Fall, Moussa Diallo and Fatimata Ly1

Introduction: Lupus disease has a wide range of clinical manifestations. Finger necrosis is often described during the disease. We report an exceptional case of isolated digital necrosis as a presenting symptom of SLE in a Senegalese of type VI prototype.

Observation: A 33-year-old man, smoker 1 pack/year, had consulted for a 3-year evolving digital necrosis and repeated amputations. On examination, the general condition was altered and the right radial pulse was not palpable. The diagnosis of lupus vasculitis was established in presence of the anti-Sm positive antibodies and ruling out of other vasculitis causes. The evolution was good under corticosteroid, antimalarial and anticoagulant therapy. No recurrence was observed after a three-year following.

Discussion: Digital necrosis is one of the late manifestations of SLE. It occurs rarely as primary or the only manifestation of SLE. Therefore, in our patient, before establishing SLE diagnosis we have ruled out as a priority, systemic scleroderma and Berger disease. The occurrence of this a typical SLE manifestation in an African man makes our observation more unusual.