(BMJ)—A woman in her 50s presented with sudden stinging at the base of her L palm, followed by the development of purple discoloration ~30 min later. Exam: no evident trauma, no pallor, normal temp of fingers, capillary refill <2 sec. Duplex U/S of radial and ulnar artery WNL. What’s the dx?

Immune thrombocytopenia
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Raynaud syndrome
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Vitamin C deficiency
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Achenbach syndrome
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Buerger disease
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