Acrocyanosis of cold agglutinin disease successfully treated with antibiotics

Two women were seen for evaluation of acrocyanosis and vasculitis limited to the toes. General studies showed only the presence of low titer cold hemagglutinins. Complete rapid clearing of the cutaneous changes was achieved after treatment with systemic cephradine in one case and penicillin in the other. This supports the view that cold agglutinins, arising as a result of occult bacterial infection, were responsible for the clinical presentation of blue toes.