Rarely a person who smokes cannabis may develop a peripheral arteritis. Its pathogenesis is a subject of debate.
Clinical features:
(1) Raynaud's phenomenon
(2) digital ulceration and/or distal infarction
(3) history of heavy cannabis use
(4) less often medium or large vessel arteritis with peripheral obstructive arterial disease
Many of the reported patients also smoke cigarettes.
Some authors believe that the condition is a variant of thrombangiitis obliterans (Buerger's) disease, which is linked to cigarette smoking.
Differential diagnosis:
(1) undisclosed cocaine or methamphetamine use
(2) cryoglobulinemia
(3) autoimmune vasculitis
(4) other causes of Raynaud's phenomenon
The diagnosis is supported by all of the following:
(1) exclusion of other causes
(2) no or little tobacco smoking
(3) resolution after discontinuation of cannabis use
