Fingerprick sites should be inspected regularly for skin necrosis in diabetic patients who have peripheral vascular disease, said Olivier Giannini, M.D., and Michael Mayr, M.D., of the University Hospitals of Basel (Switzerland).
The physicians reported the case of a 59-year-old diabetic man who was hospitalized for amputation of the lower right leg because of severe arterial occlusive disease. While recovering from the surgery, the patient took fingerprick blood samples to monitor his blood sugar. Within a few days, multiple small, well-circumscribed areas of skin necrosis around the fingerprick sites quickly progressed to full necrosis of the distal phalange, despite treatment with iloprost infusions, the investigators said (Lancet 2004;364:980).
Regular inspection of these sites may prevent such deterioration. If it does develop, capillary blood samples could be drawn from the thenar eminence, rather than the fingertips, they added.