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Syphilis presenting as the 'blue toe syndrome'

D G Federman1, M Valdivia, R S Kirsner

  • 1Department of Internal Medicine, University of Miami, School of Medicine, Fla.

Archives of Internal Medicine
|May 9, 1994
PubMed
Summary

Blue toe syndrome, characterized by painful, cyanotic toes, can stem from various causes. This case highlights secondary syphilis as a potential, often overlooked, diagnosis for blue toe syndrome.

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Area of Science:

  • Infectious Diseases
  • Dermatology
  • Vascular Medicine

Background:

  • Blue toe syndrome presents as sudden, painful, cyanotic discoloration of the toes.
  • Multiple underlying medical conditions can cause blue toe syndrome, necessitating a thorough diagnostic workup.

Observation:

  • A patient presented with blue toe syndrome where initial investigations did not reveal a typical etiology.
  • Diagnostic procedures included skin biopsy and serologic testing.

Findings:

  • The patient's presentation and diagnostic findings ultimately led to the diagnosis of secondary syphilis.
  • Treatment response further supported the diagnosis of syphilis.

Implications:

  • This case underscores the importance of considering secondary syphilis in the differential diagnosis of blue toe syndrome.
  • Clinicians should maintain a high index of suspicion for infectious causes, including syphilis, in patients with unexplained blue toe syndrome.

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