Cannabis is one of the most commonly consumed illicit psychoactive drugs and cannabis arteritis is one of its rare complications. We hereby report an interesting case of a young man who developed Raynaud&rsquo’s phenomenon and splinter hemorrhage over the fingernails following cannabis abuse.

Case report:

A 28-year-old male with anxiety disorder developed acute episodic pain associated with bluish discoloration over the fingertips, splinter hemorrhages with reddish discoloration over his right fifth, left first, and fourth fingernails following cannabis use for two weeks. Dermoscopic examination of fingernails revealed splinter hemorrhage seen as linear longitudinal red streaks, irregular pits, and subungual erythema. Serial weekly follow-up showed subungual blotchy erythematous to brownish pigmentation, onycholysis, polychromia, and leukonychia. Ultrasound of affected nails where normal and doppler ultrasound of the upper limbs revealed arteries with normal blood flow. He was treated with T.Nifedipine10mg and psychiatric counseling for his anxiety disorder. Repeated psychologist counseling and rehabilitation led to cannabis deaddiction in this patient. Serial follow-up showed gradual resolution of the lesions.


Cannabis arteritis can present as thromboangitis obliterans if not detected in the earlier stages. Thus, proper history taking and a suspicion of this condition can help prevent its dreadful sequelae.