Digital gangrene without sclerodactyly in the presence of anticentromere antibodies: A unique presentation of scleroderma

Peripheral vascular disorders associated with anti-centromere antibody (ACA) present generally with sclerodactyly in connective tissue disorders (CTD). It is unusual for ACA-associated digital necrosis to develop without preexisting raynaud's phenomena or vascular risk factors. We report a novel case of a 60-year-old non-smoker, non-diabetic woman with ACA and isolated finger necrosis without any other features of CTD. This case underscores the importance of considering an autoimmune contribution to the development of digital necrosis even without any identifiable CTD. It highlights the need to consider ACA-associated digital gangrene to be considered as a distinct entity of an autoimmune disorder from scleroderma.