RT Book, Section A1 Mintz, Ari J. A1 Mintz, Bruce A2 Dean, Steven M. A2 Satiani, Bhagwan A2 Abraham, William T. SR Print(0) ID 1105292716 T1 FROSTBITE T2 Color Atlas and Synopsis of Vascular Diseases YR 2015 FD 2015 PB McGraw-Hill Medical PP New York, NY SN 9780071749541 LK accesssurgery.mhmedical.com/content.aspx?aid=1105292716 RD 2024/03/29 AB A 48-year-old homeless man presented to the emergency department with bilateral black toes on a subzero temperature morning in January. He states that initially he felt a tingling sensation followed by clumsiness, which led to a total loss of sensation of both feet. The patient's history included tobacco smoking as well as poorly controlled diabetes mellitus. Examination revealed bilateral segments of profound, dark distal eschar, along with bullous erythema of the toes. A dusky area of mid foot tissue demarcation was apparent with segmental dark ischemic borders. Immediate amputation of the left leg was undertaken and the right foot was given a chance to demarcate over the ensuing days.