Blue Toe Syndrome
Blue toe syndrome refers to acute onset of digital ischemia which presents as painful, purplish-blue toes in the absence of any trauma, disease or injury. It is basically a form of occlusive vasculopathy. There can be various causes for ischemia including emboli, thrombosis, vasoconstricrive disorders like Raynaud phenomenon, vasculitis and even presence of abnormal constituents in blood such as in cryoglobulinemia. The chief clinical feature is the bluish discoloration of one or more toes. It may affect one or both of the feet. Apart from this, the affected toe is painful and may be accompanied with claudication and other cutaneous findings as well such as acrocyanosis, purpura or livedo reticularis. Moreover the affected area of the toe feels colder on touch compared with the rest of the foot. The treatment involves treating the underlying cause and asking the patient to go for certain lifestyle changes like cessation of smoking, controlling hypertension and hypercholestrolemia. The main aim is to relieve the occlusion which is done by prescribing anticoagulants. Apart from this, supportive treatment like hydration, appropriate dressing and keeping the affected toes warm is also beneficial. Delaying the treatment can cause ischemic loss of the digits or even the limb which eventually leads to dry gangrene requiring amputation.