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Acrocyanosis
Acrocyanosis is a vasospastic disorder
affecting the arteries supplying blood to the skin of the hands and
feet. Vasospasm refers to the arteries going into spasm and blocking
the flow of blood. These small arteries carry oxygen and nutrients
through the blood to the skin of the hands and feet. When the blood
cannot flow through, the skin will lack the necessary oxygen required,
and turn a dark blue to purple color. This characteristic color is
called cyanosis, hence the name acrocyanosis. It is not a common
condition. It is seen more frequently in woman than in men. Unlike the vasospasm seen in Raynaud's disease
which may last several minutes to several hours, the vasospasm in
acrocyanosis is more persistent. In addition, the vasospasm in
Raynaud's disease affects the small arteries supplying blood to the
fingers and toes. In acrocyanosis the vasospasm affects the arteries
supplying blood flow to the skin of the hands and/or feet. Therefore
the skin damage and ulcerations seen in Raynaud's disease are not
present in acrocyanosis. Lastly, Raynaud's disease goes through a
typical triphasic or biphasic color change. In contrast, acrocyanosis
maintains its characteristic blue skin coloration. Diagnosis Typical
symptoms and signs of acrocyanosis of the hands or feet, are a
persistently cold temperature and blue discoloration. They often feel
sweaty or moist, and swelling may be present. The blue cyanosis usually
appears worse upon exposure to cold, and improves upon warming. Rarely
is there any pain associated. Normal arterial pulses are always present
in the hands and feet since there is no blockage of the larger arteries
of the arms or legs. Treatment Generally
the treatment is a common sense approach to preventing cold exposure
and keeping the feet dry. This may involve the use of insulated boots,
thin polypropylene liner socks to wick the moisture away from the skin,
and an insulated sock to maintain normal skin temperature. Generally no
other treatment is necessary. Vasodilators have been tried with limited
success. In extreme cases a surgical procedure called a sympathectomy
has been performed to relax the persistent vasospasm. This surgery is
rarely necessary, and seldom recommended.
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