Abstract
Erasmus syndrome is a rare clinical syndrome characterized by the development of systemic sclerosis (SSc) following chronic exposure to silica; however, the presence of silicosis is not a prerequisite for this diagnosis. It is infrequently reported in the literature, and recognizing the association between occupational silica exposure and SSc is crucial for timely diagnosis and management in workplace settings. We report a case of Erasmus syndrome in a stone cutter in his late 30s, who presented with gangrene in both feet, Raynaud's phenomenon, without any evidence of other organ involvement. Anti-Scl-70 antibody was positive on the line immunoassay, supporting the diagnosis. The patient was started on a combination therapy including calcium channel blockers, phosphodiesterase 5 inhibitors, and wound care. At 6-month follow-up, he had no further disease progression with stabilization of gangrene.