Hodgkin's disease presenting with digital ischaemia

Summary A 52‐year‐old man with primary Raynaud's disease developed increasingly severe Raynaud's phenomenon with digital ischaemia in all limbs, and gangrene in two digits of the left hand. He was subsequently found to have Hodgkin's disease. Cervical sympathectomy led to initial improvement in acute ischaemia, and chemotherapy was followed by further improvement in the general severity of Raynaud's phenomenon together with remission of the lymphoma. Severe Raynaud's phenomenon is most commonly associated with connective tissue disease with characteristic changes on nailfold capillaroscopy but acute, or severe acute on chronic, digital ischaemia has been associated with malignant disease. Only two other cases have been reported with an underlying lymphoma.