To the Editor:
A novel diagnostic approach may be a helpful adjunct to clinical judgment in evaluating Churg-Strauss syndrome.
A 51-year-old African American man with a 1-year history of asthma treated with inhalers, mometasone, and monteleukast presented to his primary care provider with 6 weeks of numbness and tingling of the hands and feet followed by dusky discoloration and pain in the fourth and fifth digits of the right hand. Similar changes occurred in the left hand 1 week later. He had a nonpruritic rash with associated ulcerations of the pretibial region bilaterally. A computed tomography angiogram (CTA) of the legs demonstrated multiple focal areas of dilatation and stenosis. A beaded appearance was evident throughout the posterior tibial arteries bilaterally that extended into the common plantar and lateral plantar arteries (Figure 1).
Address correspondence to Dr. Moffett; E-mail: bkmoffett{at}insightbb.com