Gangrenous Digital Ischemia Unmasking HIV Infection in Untreated Systemic Sclerosis

We report the case of a 55-year-old woman with untreated systemic sclerosis who presented with severe digital ischemia and dry gangrene requiring toe amputation. Further investigation revealed generalised lymphadenopathy and an unexpected diagnosis of HIV infection. Lymph node biopsy revealed reactive inflammatory changes associated with systemic sclerosis. This case highlights the importance of evaluating coexisting infections in autoimmune diseases and the potential for severe vascular complications when scleroderma remains untreated, particularly in immunocompromised patients.