<s>[INST] My Mom has been diagnosed with Lupus.  Acutally in Dec her 2 fingers of the right had had turned cold and then black. It then had vasculitis and has dried.  She is been given Omnacotil 5 mg  and Zilast 100 twice a day. She was doing well. But from Yesterdaty her 2 fingers of the left hand has started getting cold and dark ( lack of blood supply ). She is daibetic and is on 3 time insulin. What should we do to save her fingers and life. She is 64 yrs old. Please help we are in Vadodara Gujarat [/INST] Hello dear, Thank you for your contact to Chat Doctor. I read and understand your concern. I am Chat Doctor answering your concern. It looks like your mothers' limb turn into necrotic changes.These changes are more common on diabetic patient. Steroids should not be advice to the diabetics as this can further complicate the problem. In my opinion you should be examined at nearby doctors. They will guide you regarding whether this blackening will revert or not. Whether there is need for surgery or not. But almost care should be taken in therapy. As this blackening can be the cause of limb amputation and can be a life-threatening condition. Please advice her to maintain good sugar level as this will be preventive in further worsening of condition. I will be happy to answer your further concern on bit.ly/ Chat Doctor. Thank you, ChatDoctorInfectious diseases specialist, ChatDoctor. </s>