Investigation and management of cutaneous arterial insufficiency of the extremities*

The effects of arterial disease may be identified most readily by examination of the skin, and that of the digits often shows the most pronounced changes. The skin may be ischaemic as part of the general arterial insufficiency to a limb or, particularly as with vasospastic disorders, may show the most exaggerated changes whilst other tissues are relatively spared. The spectrum of arterial conditions causing cutaneous arterial insufficiency is wide and ranges from vasospastic disorders, without permanent tissue damage, to conditions where there is necrosis of tissue with loss of function and leading on to gangrene.