Severe cases of systemic scleroderma and Raynaud's (as well as other illnesses) may cause a total lack of blood supply to the extremities. When this happens, necrosis (death of tissue) and gangrene may set in, sometimes making it necessary to have the affected part(s) amputated.
Gangrene sets in more frequently among scleroderma patients who smoke or use caffeine, because such substances further constrict blood vessels.
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