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Blue toe syndrome. Causes and management
S T O'Keeffe1, B O Woods, D J Breslin
1Section of Vascular Medicine and Hypertension, Lahey Clinic Medical Center, Burlington, MA 01805.
Insights
Sudden cyanotic foot lesions can stem from atheroembolic disease or other conditions. Differentiating medical from surgical causes guides treatment, though atheroembolic disease management requires further research.
Area of Science:
- Vascular Medicine
- Dermatology
Background:
- Sudden onset of cyanotic lesions on the feet presents a diagnostic challenge.
- Differential diagnoses include atheroembolic disease and various other medical conditions.
Purpose of the Study:
- To outline the diagnostic approach for cyanotic foot lesions.
- To discuss the management strategies for atheroembolic disease versus other medical causes.
Main Methods:
- Clinical history and physical examination.
- Basic laboratory investigations.
- Noninvasive vascular assessment.
Main Results:
- A systematic approach can differentiate between medical and surgical etiologies.
- Medical conditions causing cyanotic lesions often have specific therapies available.
Conclusions:
- Initial evaluation effectively distinguishes between medical and surgical causes.
- Management of atheroembolic disease remains controversial, necessitating further research into optimal surgical versus medical treatment strategies.
Abstract:
The sudden development of cyanotic lesions on the feet may be a result of atheroembolic disease or a number of medical conditions. A careful history and physical examination, basic laboratory tests, and noninvasive vascular assessment usually distinguish between medical and surgical causes and direct the choice of further investigations. Specific therapy is often available for medical conditions causing this syndrome. The management of atheroembolic disease is more controversial. In particular, further research is necessary to determine which patients need surgical intervention and which patients can be managed safely by medical therapy.