[Fingertip necroses of unknown origin].

A 63-year old woman presented with dry necrotic areas on the distal and medial phalanges of her right index and middle finger caused by burns while smoking. Differential diagnostic considerations included occlusive arterial disease, vasculitis, endangiitis obliterans, peripheral embolisms and exposure to chemicals. The patient had the habit of smoking her cigarettes until the last possible drag, putting her skin in direct contact with the burning tobacco.