The Purple Digit

Brown, Patrick J.; Zirwas, Matthew J.; English, Joseph C.

doi:10.2165/11530180-000000000-00000

Cited by 32 publications

(10 citation statements)

References 153 publications

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“…It may be difficult to decide which of the two terms is more appropriate. A practical diagnostic algorithm of a ‘purple digit’ was offered by Brown et al 149 and may be well applied to differentiate secondary acrocyanosis from similar conditions (Figures 2 and 3). …”

Section: Secondary Acrocyanosismentioning

confidence: 99%

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Acrocyanosis: The Flying Dutchman

2011

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Acrocyanosis is symmetric, painless, discoloration of different shades of blue in the distal parts of the body that is marked by symmetry, relative persistence of the skin color changes with aggravation by cold exposure, and frequent association with local hyperhidrosis of hands and feet. Described over a century ago and despite seeming familiarity, it remains a poorly understood condition that shares much in clinical presentation with other conditions characterized by skin color changes in the distal parts of the body. The diagnosis remains mostly clinical, and pathological mechanisms vary suggesting that acrocyanosis may not be a single entity. We performed an extensive literature review to summarize existing knowledge about the demographics, pathology, diagnosis, and treatment of this condition.

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Section: Secondary Acrocyanosismentioning

confidence: 99%

Section: Figurementioning

confidence: 99%

Acrocyanosis: The Flying Dutchman

2011

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“…Additionally, both Raynaud's disease and Raynaud's phenomenon, in contrast to PVD, are only weakly related to glaucoma. Furthermore, PVD is also not identical with the so-called purple digit syndrome [56]. …”

Section: Vascular Dysregulationmentioning

confidence: 99%

The primary vascular dysregulation syndrome: implications for eye diseases

2013

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Vascular dysregulation refers to the regulation of blood flow that is not adapted to the needs of the respective tissue. We distinguish primary vascular dysregulation (PVD, formerly called vasospastic syndrome) and secondary vascular dysregulation (SVD). Subjects with PVD tend to have cold extremities, low blood pressure, reduced feeling of thirst, altered drug sensitivity, increased pain sensitivity, prolonged sleep onset time, altered gene expression in the lymphocytes, signs of oxidative stress, slightly increased endothelin-1 plasma level, low body mass index and often diffuse and fluctuating visual field defects. Coldness, emotional or mechanical stress and starving can provoke symptoms. Virtually all organs, particularly the eye, can be involved. In subjects with PVD, retinal vessels are stiffer and more irregular, and both neurovascular coupling and autoregulation capacity are reduced while retinal venous pressure is often increased. Subjects with PVD have increased risk for normal-tension glaucoma, optic nerve compartment syndrome, central serous choroidopathy, Susac syndrome, retinal artery and vein occlusions and anterior ischaemic neuropathy without atherosclerosis. Further characteristics are their weaker blood–brain and blood-retinal barriers and the higher prevalence of optic disc haemorrhages and activated astrocytes. Subjects with PVD tend to suffer more often from tinnitus, muscle cramps, migraine with aura and silent myocardial ischaemic and are at greater risk for altitude sickness. While the main cause of vascular dysregulation is vascular endotheliopathy, dysfunction of the autonomic nervous system is also involved. In contrast, SVD occurs in the context of other diseases such as multiple sclerosis, retrobulbar neuritis, rheumatoid arthritis, fibromyalgia and giant cell arteritis. Taking into consideration the high prevalence of PVD in the population and potentially linked pathologies, in the current article, the authors provide recommendations on how to effectively promote the field in order to create innovative diagnostic tools to predict the pathology and develop more efficient treatment approaches tailored to the person.

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“…Perniosiste soğuk maruziyeti sonrası özellikle el ve ayakların dorsal yüzlerinde eritemli, morumsu papüller, nodüller, ülserasyon, nekroz, vesikül ve büller görülebilir. Raynaud fenomeninde, sıklıkla üst ekstremite tutulumu görülür ve lezyonların sınırları embolideki gibi keskin değildir (7). Olgumuzun soğuk maruziyeti ile ilişkisiz semptomları ve lezyonların karakteristiği, bizi vazokonstruktif bozukluklardan uzaklaştırdı.…”

Section: Discussionunclassified

A rare clinical picture: Blue toe syndrome

Türel

Kırık

Dolapoglu

et al. 2021

Balıkesir Medical Journal

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Blue toe sendromu; mikrovasküler oklüzyona bağlı bir veya daha fazla ayak parmağında veya ayak tabanında ağrı ve siyanoz ile karakterize klinik durumdur. En sık nedeni ateroembolik hastalıklar veya anevrizmadır. Embolizasyon genellikle aorto-iliak arter ve femoral arterlerde bulunan ülsere aterosklerotik plaktan veya anevrizmadan meydana gelir. Blue toe sendromu gelişen bir hastada emboli kaynağını tespit ve tedavi etmek, uzuv kaybı ve/veya ölüm ile sonuçlanabilecek tekrarlayan embolileri önlemek adına oldukça önemlidir. Bununla birlikte yukarıda belirtilen klinik semptomlarla başvuran hastada yapılan ilk fizik muayenede periferik nabızların palpabl olması klinisyenleri vasküler patolojilerden uzaklaştırmakta, buna bağlı tanı koymada gecikme söz konusu olabilmektedir. Bu hastalarda mikrovasküler oklüzyondan şüphelenilmesi ve damar içi patolojileri teşhis için görüntüleme yöntemlerine başvurulması hayati önem arz etmektedir. Olgumuzda her iki ayak tabanında yürümekle şiddetlenen ağrı ve mavi/mor renk değişikliği mevcuttu. Fizik muayenede periferik nabızlar palpabl idi. BTA görüntüleri ve mevcut lezyonlardan yapılan biyopsi sonuçları, klinik bulgular eşliğinde değerlendirildiğinde blue toe sendromu tanısı konuldu.

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The Purple Digit

Cited by 32 publications

References 153 publications

Acrocyanosis: The Flying Dutchman

Acrocyanosis: The Flying Dutchman

The primary vascular dysregulation syndrome: implications for eye diseases

A rare clinical picture: Blue toe syndrome

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