Scroll down and see all the pictures. Due to the high quality they may be slow in loading up but they are so clear that I do not feel like compromising the quality in exchange for faster loading. Notice the gangrene setting in in the patient's hands. Note the second hand too the tips of fingers from that are seen. The elbow region has the most obvious calcinosis I have ever seen. See the sclerodactily and infarcts of the fingertips. The serum marker for this is SCL-70. A common question that is asked is the drug of choice for hypertensive emergencies of scleroderma - the answer is ACE inhibitors. There is no effective treatment for the progression of scleroderma.

Such may be the picture in any vasculitis - including Infective endocarditis where the digits can get gangrenous.

Note the soft tissue calcification in this patient with CREST syndrome.