4th August 2020

A 27-year-old male presents with ulcerative lesions with necrotic tissue

A 27-year-old male presents with ulcerative lesions with necrotic tissue, across the 2nd, 3rd and 4th toes of his right foot. He complains of severe pain on walking. He has a previous trans-metatarsal amputation on his left foot. He also complains of intermittent painful attacks when his fingers turn white, then blue. He has smoked 10 cigarettes a day for 10 years. His HbA1c is 39 mmol/L. 

For the patient above, please select the SINGLE most likely underlying diagnosis. Select ONE option from the list above.