Symmetrical peripheral gangrene and extremity amputations

Symmetrical peripheral gangrene (SPG) is a rare syndrome. It is characterized by bilateral distal ischemia leading to gangrene, in the absence of major vascular occlusive disease. It is considered a cutaneous marker of disseminated intravascular coagulation, and more than half of the patients who survive require amputation of the affected limb(s). The etio-pathogenesis of SPG is not well understood, but the hallmark is the occurrence of microcirculatory failure. We present two patients with SPG. The aim of this report is to sensitize and to help make the diagnosis easier for the clinician. Patients who are identified to be at risk require frequent observation and examination of the appearance of their distal extremities, nose, and ears. No treatment is universally effective. It should be individualized according to the underlying disease and patient′s general condition. The guiding principle is prompt identification and reduction or removal of aggravating factors.