Acral necrosis

Overview
Acral necrosis is a symptom common in bubonic plague.

Etymology
The striking black discoloration of skin and tissue, primarily on the extremities, is commonly thought to have given rise to the name "Black Death," associated both with the disease and the pandemic which occurred in the 14th century. The term in fact came from the figural sense of "black", that is glum, lugubrious or dreadful.

Clinical Findings
Clotting and bleeding beneath the skin causes an area of hemorrhage, the presence of red blood cells lying outside of capillaries, into the skin and subcutaneous tissue. In isolation, this is called an ecchymosis or bruise and may be the result of injury or illness. However, acral necrosis occurs when blood supply is disrupted for prolonged periods, blackening and damaging the affected area and surrounding tissue.

Treatment
With appropriate medical treatment, areas with Acral necrosis may be successfully restored to function.

Prognosis
Untreated cases can lead to death.

Pathological Findings
Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology