Smoker with an Ulcer on the Tip of the Finger

Smoker with an Ulcer on the Tip of the Finger

A 39-year-old man with a 22-year history of smoking one to two packs of cigarettes per day was referred to hyperbaric facility because of an ulcer on the tip of the third finger of his right hand that had been present for six months.

He had a four-year history of blanching and coldness of the fingers on exposure to cold, and a previous ulcer of the tip of the left index finger had healed when he stopped smoking. The second ulcer appeared when he resumed smoking, but it did not heal when he again stopped smoking.

What’s the Diagnosis ?