This smoker presented with a four-year history of blanching of the fingers on exposure to cold. What is the diagnosis?

Answer A. Thromboangiitis obliterans Thromboangiitis obliterans is a vaso-occlusive disease that involves small- and medium-sized vessels of the upper and lower extremities. It is strongly associated with tobacco use. An angiogram of this patient's right hand demonstrated multiple chronic occlusions of the digital branches that were unresponsive to intraarterial vasodilators, supporting the diagnosis of thromboangiitis obliterans.