Fig. 2.

Ischemic and dermatologic changes in Patient D at three months following TGN1412-induced cytokine storm. Areas of dry gangrene became fully demarcated at 2–3 months following the insult with vascular skin changes in the areas that became revigorated. Shown are changes prior to amputation of the ischemic digits in the (a) left hand and (b) right foot. Following amputations, he had persistent pain in both feet, some of which could be ascribed to phantom-limb pain, and had a sensory deficit which followed a glove-and-stocking distribution, consistent with the areas originally affected by ischemia during his critical illness. (c) During the patient’s critical care phase, an arterial line had been placed in the left radial artery and with recovery, a hyperkeratotic scar formed, 7 cm × 4 cm in maximum dimensions, with faint satellite amelanotic lesions (1–3 mm dimension, arrows). These lesions continued to improve with time, with regression of the scar and disappearance of the white satellite spots