Thrombangiitis obliterans (Burger’s disease) is a vanishingly rare disease in USA, but is still a problem in some developing countries.
Clinical features of the disease include:
- Very strong association with smoking, especially unprocessed and unfiltered tobacco products.
- More common in males than females
- Painful violaceous lesions on distal extreminties, especially fingers and toes.
- Sensation of coldness.
- Resolution after cessation of smoking
- Visceral involvement exceptionally rare but can occur.
Histological features include:
- Involvement of small to medium sized arteries and (rarely) veins
- Intravascular thrombosis.
- Mixed inflammation infiltrate in vessel wall with numerous neutrophils
- Intravascular abscesses can be associated with intravascular thrombi or be present within a vessel wall
- Preserved internal elastic lamina
- Intravascular thrombi recanalize during resolution