Persistent Acrocyanosis—A Rare Manifestation Revealing Anti–PL‐12 Syndrome

A 69‐year‐old woman with asthenia, anorexia and weight loss lasting for several weeks was referred for a subacute onset of painful permanent acrocyanosis of the four extremities without Raynaud's phenomenon. She also had concomitantly developed grade I/IV (NYHA) dyspnea. A physical examination revealed livedoid acrocyanosis of distal phalanges of the hands (Fig. 1A), which was associated with flame‐shaped hemorrhages (Fig. 1B, arrow‐head), dilated capillaries at the proximal nailfolds (Fig. 1B, arrow), Gottron's sign over the MCP and PIP joints and a discrete heliotrope rash with a palpable V‐shaped rash of the upper chest and forehead. This article is protected by copyright. All rights reserved.