Abstract
To the Editor:
I read with interest the letter from Dr Windsor, Dr Richards, and Dr Rodway 1 concerning painful fissuring of the fingers that has been seen in those who spend periods of time either at altitude or in polar regions.
I agree that such environments would certainly be associated with the development of these fissures. However, while I am impressed with the suggested mechanism linking diabetes and fissure formation, it is by no means certain. Fissuring of fingers is relatively common, even in temperate climates such as the UK, during the winter months (see Figure). This fissure was acquired in the south of Britain during November, when the ambient temperature did not go below freezing, and while the subject was wearing gloves. The diabetes link, although at first glance tempting, does not seem necessary to explain the fissuring experienced by the climber on Cho Oyu.
Healing fissure on finger pulp in a healthy nondiabetic.
It is perhaps more likely that the rest of the climbing team were just fortunate in not being susceptible to this minor, but most unpleasant, condition.