Long-standing carpal tunnel syndrome (CTS) may rarely be associated with digital skin ulceration.
Clinical features:
(1) presence of carpal tunnel syndrome
(2) chronic duration
(3) severe motor, sensory and autonomic neuropathy with paresthesias
(4) painless digital erosions or ulcers in the distal second and third digits
(5) variable changes in the fingernails of the affected fingers
(6) exclusion of other conditions that could explain digital ulcers
(7) variable nocturnal pain in the fingers
