Acrocyanosis is persistent bluish discoloration of the extremities, worsened by cold temperatures. This condition is due to decreased deoxyhemoglobin in the peripheral vasculature that may be primary (ie, unknown etiology) or secondary (ie, due to underlying pathology).
Primary acrocyanosis is asymptomatic, affects digits symmetrically, and is not associated with increased morbidity or mortality. It is most often seen in patients in their 20s and 30s and completely resolves in many women after menopause. The cyanotic discoloration seen in primary acrocyanosis is due to vasospasm in the cutaneous arterioles. Cold climate, outdoor occupation, and low body mass index are risk factors for developing acrocyanosis.
Secondary acrocyanosis can be symmetrical or asymmetrical, and it is sometimes associated with pain and necrosis of the affected extremities. As opposed to primary acrocyanosis, secondary acrocyanosis results from an underlying systemic pathology. It has been associated with many etiologies, including connective tissue diseases, Buerger disease, stroke, myocardial infection, lung diseases causing hypoxia, eating disorders, hematologic disorders, neoplasms, drug exposures, genetic diseases, spinal cord injury, and infections.
ICD10CM: I73.89 – Other specified peripheral vascular diseases
SNOMEDCT: 25003006 – Acrocyanosis
Differential Diagnosis & Pitfalls
Raynaud phenomenon – paroxysmal episodes of well-demarcated cutaneous pallor and cyanosis followed by erythema
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.
Acrocyanosis is a persistent blue coloration of the hands and feet caused by a vascular disorder in the extremities. Cold temperatures worsen the condition.
Primary acrocyanosis is often seen in patients in their 20s and 30s. It typically has no other symptoms and is not associated with additional health problems.
Secondary acrocyanosis can result from the presence of another disease, infection, or drug reaction.
Who’s At Risk
You are at a higher risk of developing primary acrocyanosis if you are exposed to cold temperatures, have a low body mass index, or work outdoors.
You may be more likely to acquire secondary acrocyanosis if you already have a certain type of lung, blood, or heart disease, spinal cord injury, eating disorder, malignancy, or a family history of acrocyanosis.
Signs & Symptoms
The most common symptom of acrocyanosis is a bluish-to-red discoloration of hands and feet, often aggravated by the cold. You may find the soles of your feet and your palms are excessively sweaty.
If you have secondary acrocyanosis, it may be accompanied by pain and ulceration in your hands, feet, or other affected areas.
Follow these guidelines to help reduce symptoms:
Wear gloves and warm socks
If you work outdoors in a cold climate, wear insulated clothing
When to Seek Medical Care
Seek medical care if symptoms negatively affect your daily life or if they worsen over time.
For primary acrocyanosis, the best treatment is to avoid cold exposure.