Blue toe syndrome

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Blue toe syndrome
Blue toe syndrome- ischaemia (DermNet NZ blue-toe-syndrome-002).jpg

Blue toe syndrome is a situation that may reflect atherothrombotic microembolism, causing transient focal ischaemia, occasionally with minor apparent tissue loss, but without diffuse forefoot ischemia.[1] The development of blue or violaceous toes can also occur with trauma, cold-induced injury, disorders producing generalized cyanosis, decreased arterial flow, impaired venous outflow, and abnormal circulating blood.[2][3][4][5] The terms "blue toe syndrome", "grey toe syndrome" and "purple toe syndrome" are sometimes used interchangeably.[6]

Studies may include echocardiography, thoracic and abdominal CT or MRI,[7][8][9][10] peripheral arterial run off imaging studies, hypercoagulopathy labs, and interrogation of syndromes that lead to peripheral vascular pathology.[11]

Adapted from Hirschmann JV, Raugi GJ. J Am Acad Dermatol 2009 (DermNet NZ Causes-of-blue-toe-syndrome-diagram).jpg

See also


  1. "'Standards for vascular reporting'" (PDF). Archived from the original on 2020-07-29. Retrieved 2023-10-27.
  2. Matchett WJ, McFarland DR, Eidt JF, Moursi MM (2000). "Blue toe syndrome: treatment with intra-arterial stents and review of therapies". J Vasc Interv Radiol. 11 (5): 585–92. doi:10.1016/s1051-0443(07)61610-8. PMID 10834489.
  3. Applebaum RM, Kronzon I (1996). "Evaluation and management of cholesterol embolization and the blue toe syndrome". Curr Opin Cardiol. 11 (5): 533–42. doi:10.1097/00001573-199609000-00013. PMID 8889381.
  4. Sottiurai VS, Omlie W (1994). "Femoral artery hypoplasia and persistent sciatic artery with blue toe syndrome: a case report, histologic analysis and review of the literature". Int Angiol. 13 (2): 154–9. PMID 7963875.
  5. Choi KH, Yoo J, Huh JW, Jeong YI, Kim MS, Jue MS, Park HJ (2016). "Blue Toe Syndrome as an Early Sign of Disseminated Intravascular Coagulation". Ann Dermatol. 28 (3): 400–1. doi:10.5021/ad.2016.28.3.400. PMC 4884725. PMID 27274647.
  6. Hirschmann JV, Raugi GJ (January 2009). "Blue (or purple) toe syndrome". J. Am. Acad. Dermatol. 60 (1): 1–20, quiz 21–2. doi:10.1016/j.jaad.2008.09.038. PMID 19103358.
  7. Kopani K, Liao S, Shaffer K (2009). "The Coral Reef Aorta: Diagnosis and Treatment Following CT". Radiol. Case Rep. 4 (1): 209. doi:10.2484/rcr.v4i1.209. PMC 5106526. PMID 27843516.
  8. Belczak SQ, Sincos IR, Aun R, Costa KV, Araujo EA (Apr 2014). "Coral reef aorta, emergency surgical: case report and literature review". Einstein (Sao Paulo). 12 (2): 237–41. doi:10.1590/s1679-45082014rc2772. PMC 4891170. PMID 25003933.
  9. Schulte KM, Reiher L, Grabitz L, Sandmann W (Nov 2000). "Coral reef aorta: a long-term study of 21 patients". Ann Vasc Surg. 14 (6): 626–33. doi:10.1007/s100169910091. PMID 11128458. S2CID 25265011.
  10. Policha A, Moudgill N, Eisenberg J, Rao A, DiMuzio P (2013). "Coral reef aorta: case report and review of the literature". Vascular. 21 (4): 251–9. doi:10.1177/1708538113478764. PMID 23518854. S2CID 63550.
  11. Blackshear JL, Oldenburg WA, Cohen MD (Dec 1994). "Making the diagnosis when the patient has 'blue toes'". Geriatrics. 49 (12): 37–9, 43–5. PMID 7982584.

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