Digital Necrosis: A Hoarder’s Tale

Extreme self-neglect is a problem amongst a small but significant proportion of the population. The hand surgeon encounters cases of acute digital ischemia with a wide spectrum of aetiologies. These include thrombosis, trauma and iatrogenic causes.1 A hoarding disorder is characterised by an individual who acquires an excessive number of items and stores them in a chaotic manner.2 Hoarding is a serious concern to communities and to individuals, causing distress to the individual and those around them and putting both at risk of fire, falls, infection and infestation.2 The condition is particularly challenging to treat, since individuals have little insight of how it is impacting their lives, with extreme self-neglect being a common problem.3-5 We describe a remarkable case of a patient losing their finger due to completely avoidable circumstances, an extraordinary case of finger necrosis following prolonged external compression from a ring in a chronic hoarder. Indeed, the only reason our patient attended hospital was because his sister made a visit to his home and noticed his swollen, and discoloured finger.