Acrocyanosis

Eddie Needham, MD, FAAFP Reviewed 06/2017
 


BASICS

DESCRIPTION

  • Painless, symmetric, distal bluish discoloration usually affecting hands and feet (1)

    • Affected areas can be cool.

  • Does not come and go like Raynaud phenomenon (RP)

    • RP has a broad di...

DIAGNOSIS

HISTORY

  • Painless blue fingers, hands, toes, or feet

  • Digits may often feel cool.

  • Symptoms worse with cooler temperatures

  • Onset in 2nd or 3rd decade

  • Symptoms are long-standing but not generally pro...

TREATMENT

GENERAL MEASURES

  • Keep extremities warm.

  • Avoid inciting situations (outdoor weather without warm clothes, sitting under the AC at work, etc.).

  • Patient education and reassurance is quite helpful.

MEDICATION

ONGOING CARE

FOLLOWUP RECOMMENDATIONS

  • Most patients do well.

  • Progression to digital or limb ulceration does not happen in acrocyanosis. If so, reconsider diagnosis to include vasculitis syndromes.

MONITORING

REFERENCES

Kurklinsky AK, Miller VM, Rooke TW. Acrocyanosis: the Flying Dutchman. Vasc Med.  2011;16(4):288–301. [View Abstract on OvidInsights]
Haimovici H, Mishima Y. Nonatherosclerotic diseas...

CODES

ICD10

I73.89 Other specified peripheral vascular diseases 

ICD9

  • 443.89 Other specified peripheral vascular diseases

SNOMED

  • 25003006 acrocyanosis (finding)

PEARLS

  • Acrocyanosis is generally benign.

  • Acrocyanosis is persistent; RP is intermittent.

  • Acrocyanosis does not respond to calcium channel blockers (1); RP does.

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