Medicine:Blue toe syndrome

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Blue toe syndrome

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.[1] 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[2] 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.[3][4][5][6] The terms "blue toe syndrome," "grey toe syndrome," and "purple toe syndrome" are often used interchangeably.[7]

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.[8] 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.[9] Diagnostic evaluation may include echocardiography, thoracic or abdominal CT or MRI,[10][11][12][13] peripheral arterial imaging, blood tests for hypercoagulable states, and assessment for conditions that affect peripheral blood flow.[14]

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. https://www.sciencedirect.com/science/article/pii/S0190962208012188. 
  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. PMID 31896856. PMC 6862376. https://pmc.ncbi.nlm.nih.gov/articles/PMC6862376/. 
  3. ↑ "Blue toe syndrome: treatment with intra-arterial stents and review of therapies". J Vasc Interv Radiol 11 (5): 585–92. 2000. doi:10.1016/s1051-0443(07)61610-8. PMID 10834489. 
  4. ↑ "Evaluation and management of cholesterol embolization and the blue toe syndrome". Curr Opin Cardiol 11 (5): 533–42. 1996. doi:10.1097/00001573-199609000-00013. PMID 8889381. 
  5. ↑ "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. 1994. PMID 7963875. 
  6. ↑ "Blue Toe Syndrome as an Early Sign of Disseminated Intravascular Coagulation". Ann Dermatol 28 (3): 400–1. 2016. doi:10.5021/ad.2016.28.3.400. PMID 27274647. 
  7. ↑ "Blue (or purple) toe syndrome". J. Am. Acad. Dermatol. 60 (1): 1–20; quiz 21–2. January 2009. 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. PMID 31896856. PMC 6862376. https://pmc.ncbi.nlm.nih.gov/articles/PMC6862376/. 
  9. ↑ Motamedi, Melika; Chahade, Jadin; Gniadecki, Robert; Yacyshyn, Elaine (2025-03-17). "A review and approach to the diagnosis of blue toe syndrome" (in en). Discover Medicine 2 (1): 77. doi:10.1007/s44337-025-00275-z. ISSN 3004-8885. https://doi.org/10.1007/s44337-025-00275-z. 
  10. ↑ "The Coral Reef Aorta: Diagnosis and Treatment Following CT.". Radiol. Case Rep. 4 (1): 209. 2009. doi:10.2484/rcr.v4i1.209. PMID 27843516. 
  11. ↑ "Coral reef aorta, emergency surgical: case report and literature review". Einstein (Sao Paulo) 12 (2): 237–41. Apr 2014. doi:10.1590/s1679-45082014rc2772. PMID 25003933. 
  12. ↑ "Coral reef aorta: a long-term study of 21 patients". Ann Vasc Surg 14 (6): 626–33. Nov 2000. doi:10.1007/s100169910091. PMID 11128458. 
  13. ↑ "Coral reef aorta: case report and review of the literature". Vascular 21 (4): 251–9. 2013. doi:10.1177/1708538113478764. PMID 23518854. 
  14. ↑ "Making the diagnosis when the patient has 'blue toes'". Geriatrics 49 (12): 37–9, 43–5. Dec 1994. PMID 7982584. 

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