Cyanosis involving the hands and toes of a 12-year-old girl was first noted 3 months before medical evaluation was sought. Her fingers and palms were red, the nail beds were cyanotic, and her palms were cold and sweaty. The girl’s toes were cyanotic when she was standing. Her hands and feet reverted to a normal color when the limbs were elevated. The remainder of the physical examination was normal.
This presentation is typical of acrocyanosis—a benign condition that is most common in teenaged girls.1 Localization to the extremities and no involvement of the lips can help differentiate acrocyanosis from more serious forms of cyanosis. The persistent rather than intermittent nature of this condition and the relatively mild symptoms help rule out Raynaud’s disease.
Since acrocyanosis intensifies with exposure to cold, this patient was advised to wear gloves and warm socks in cold weather.
1. Moschella SL, Hurley HJ. Dermatology. 3rd ed. Philadelphia: WB Saunders Co; 1992:1147.