Blue toe syndrome

Blue toe syndrome
SpecialtyCardiology Edit this on Wikidata

Blue toe syndrome is defined as one or more toes developing discoloration that usually appears blue or purple with the absence of any obvious trauma (physical or cold-induced) and disorders that would cause blue toes. This occurs when small clots, often from atherothrombotic microembolism (clots formed from fatty deposits in artery walls), partially block blood flow to the toes.

Overview

The term blue toe syndrome (BTS) was created by Karmody in 1976 BTS can cause transient focal ischemia and occasionally minor tissue loss, but generally does not affect the entire forefoot. Blue or violaceous toes can also result from trauma, cold-induced injury, disorders causing generalized cyanosis, reduced arterial blood flow, impaired venous drainage, or blood abnormalities which are different than BTS. The terms "blue toe syndrome," "grey toe syndrome," and "purple toe syndrome" are often used interchangeably.

Diagnosis

There can be many underlying causes of blue toe syndrome so a diagnosis often requires a more in-depth evaluation of the patients medical history. Peripheral microembolism with distal arterial occulsion is one of the most common underlying conditions. The six primary categories of diagnosis that are outlined for blue toe syndrome include vascular obstruction, autoimmune conditions, hyperviscity syndromes, infections, drugs-induced and vasospasm. Diagnostic evaluation may include echocardiography, thoracic or abdominal CT or MRI, peripheral arterial imaging, blood tests for hypercoagulable states, and assessment for conditions that affect peripheral blood flow.

See also

References

  1. ↑ Hirschmann, Jan V.; Raugi, Gregory J. (2009-01-01). "Blue (or purple) toe syndrome". Journal of the American Academy of Dermatology. 60 (1): 1–20. doi:10.1016/j.jaad.2008.09.038. ISSN 0190-9622.
  2. ↑ Tartari, Federico; Di Altobrando, Ambra; Merli, Yuri; Patrizi, Annalisa; Mirelli, Michele; Bianchi, Tommaso (2019). "Blue Toe Syndrome: A Challenging Diagnosis". Indian Journal of Dermatology. 64 (6): 506–507. doi:10.4103/ijd.IJD_580_18. ISSN 1998-3611. PMC 6862376. PMID 31896856.
  3. ↑ 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.
  4. ↑ 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.
  5. ↑ 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.
  6. ↑ 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.
  7. ↑ 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.
  8. ↑ Tartari, Federico; Di Altobrando, Ambra; Merli, Yuri; Patrizi, Annalisa; Mirelli, Michele; Bianchi, Tommaso (2019). "Blue Toe Syndrome: A Challenging Diagnosis". Indian Journal of Dermatology. 64 (6): 506–507. doi:10.4103/ijd.IJD_580_18. ISSN 1998-3611. PMC 6862376. PMID 31896856.
  9. ↑ Motamedi, Melika; Chahade, Jadin; Gniadecki, Robert; Yacyshyn, Elaine (2025-03-17). "A review and approach to the diagnosis of blue toe syndrome". Discover Medicine. 2 (1): 77. doi:10.1007/s44337-025-00275-z. ISSN 3004-8885.
  10. ↑ 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.
  11. ↑ 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.
  12. ↑ 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.
  13. ↑ 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.
  14. ↑ 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.