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There are also a number of other conditions that affect hands, feet, and parts of the face with associated skin color changes that need to be differentiated from acrocyanosis: Raynaud phenomenon, pernio, acrorygosis, erythromelalgia, and blue finger syndrome. The diagnosis may be challenging in some cases, especially when these syndromes co-exist.
Blue toe syndrome is a situation that may reflect atherothrombotic (clots resulting from the build-up of fats, cholesterol, and other substances in and on the artery walls) [1] microembolism, causing transient focal ischaemia, a temporary blockage of blood flow to the brain or spinal cord, [2] occasionally with minor apparent tissue loss, but without diffuse forefoot ischemia. [3]
Furthermore, mongolian spots, large birthmarks, and the consumption of food products with blue or purple dyes can also result in the bluish skin tissue discoloration and may be mistaken for cyanosis. [ 2 ] [ 3 ] Appropriate physical examination and history taking is a crucial part to diagnose cyanosis.
Raynaud syndrome, also known as Raynaud's phenomenon, is a medical condition in which the spasm of small arteries causes episodes of reduced blood flow to end arterioles. [1] Typically the fingers, and, less commonly, the toes, are involved. [1] Rarely, the nose, ears, nipples, or lips are affected. [1]
Purple, red, yellow, slate, or blue-grey pigmented macules on the extremities and trunk – drug eruption: Antimalarials: Blue-ish pigmentation of lower extremities, but can also involve the entire nail bed, nose, cheeks, forehead, ears, and oral mucosa: Psychotropic Drugs: Blue-gray pigmentation on sun-exposed areas Amiodarone
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Both of these conditions cause cyanosis, or a bluish discoloration of skin or mucous membranes. [4] Normally, oxygenated blood appears red and deoxygenated blood has more of a blue appearance. [5] In babies with low levels of oxygen or mixing of oxygenated and deoxygenated blood, the blood can have a blue or purple color, causing cyanosis. [6]
Schamberg's disease is a skin disorder that causes a discoloration of the lower extremities. [4] It usually occurs in the lower extremities and rarely elsewhere. [4] This condition is caused by leaky blood vessels near the surface of the skin. [7] The cause of the leaky capillaries is usually not known. [7]