A 31-year-old Woman with Painful Black Palms: Thrombosis or Vasculitis?

Both of vaso-occlusive incidence of antiphospholipid syndrome (APS) or vasculitis secondary to systemic lupus erythematosus (SLE) can lead to gangrene, which requiring the urgent and appropriate therapeutic approach. However, it is sometimes difficult to achieve the differential diagnosis, especially when a tissue biopsy is difficult to obtain or is clinically contraindicated. Herein we report and discuss such a female patient who suffered rare progressive gangrene of palm skin and successfully treated with aggressive anticoagulation and immunosuppressive therapy.