Acrocyanosis

Faraz Ghoddusi, MD, Stacey A. Ghoddusi, MPH and Gabriel T. Harris, MD, FAAFP Reviewed 06/2018
 


BASICS

DESCRIPTION

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

    • Peripheral parts: Ear, nose, and nipple can be affected.

    • Affected areas can be cool.

  • O...

DIAGNOSIS

HISTORY

  • Painless blue fingers, hands, nose, lips, toes, or feet

  • Digits may often feel cool.

  • Symptoms worsen with cooler temperatures

  • Onset typically in 2nd or 3rd decade

  • Symptoms are long-standin...

TREATMENT

GENERAL MEASURES

  • Keep extremities warm with insulated clothing.

  • Behavioral changes to avoid inciting situations: outdoor weather without warm clothes, sitting under the AC at work, smoking ces...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Most patients do well.

  • Progression to digital or limb ulceration or pain does not typically occur with acrocyanosis. If so, reconsider diagnosis to include vasculi...

REFERENCES

Das S, Maiti A. Acrocyanosis: an overview. Indian J Dermatol.  2013;58(6):417–420.  [View Abstract]
Nousari H, Kimyai-Asadi A, Anhalt G. Chronic idiopathic acrocyanosis. J Am Acad Der...

ADDITIONAL READING

Haimovici H, Mishima Y. Nonatherosclerotic diseases of small arteries. In: Ascher E, Hollier L, Strandness DE, et al, eds. Vascular Surgery. 5th ed. Malden, MA: Blackwell; 2004:47...

CODES

ICD10

I73.89 Other specified peripheral vascular diseases 

ICD9

  • 443.89 Other specified peripheral vascular diseases

SNOMED

  • 25003006 acrocyanosis (finding)

CLINICAL PEARLS

  • Acrocyanosis is generally benign.

  • Acrocyanosis is persistent; RP is intermittent.

  • Make sure secondary etiology is ruled out.

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