What are some of the presenting symptoms of Thromboangiitis Obliterans that prompt the patient to seek medical attention?
a) Claudication, pain at rest, and digital ulceration are the primary manifestations. Because the disease starts distally, dysesthesias, sensitivity to cold, rubor, or cyanosis prompts the patient to seek medical attention in one-third of cases.
b) Pedal (instep) claudication is characteristic of TO, and patients often seek special shoes or orthopedic or podiatry care before the process is fully appreciated.
c) Gangrene and ulceration or rest pain is the presenting complaint in 33% to 66% of the patients. This occurs predominantly in the toes and fingers with up to 20% having both involved at the time of presentation. It may occur spontaneously but more often follows trauma, such as nail trimming or pressure from tight shoes.
d) Superficial migratory phlebitis: may be first manifestation of TO.
