[Pheochromocytoma manifesting as toe necrosis].

BACKGROUND

Cutaneous manifestations of pheochromocytoma other than sweating, and facial pallor during paroxysmal episodes of hypertension are exceptional.

CASE REPORT: We observed partial necrosis of the fourth toes which revealed pheochromocytoma.

DISCUSSIONS: Signs of peripheral vascular disease are uncommon during the course of pheochromocytoma. Only four cases have been reported in the literature. Occurrence of distal necrosis in combination with hypertension and palpable pulses is suggestive of pheochromocytoma requiring assay of urinary catecholamines. The pathogenic mechanisms of necrosis would be vasospasm of cutaneous vessels due to excessive plasmatic catecholamine levels and thrombocytosis as an aggravating factor.