<\/span><\/h2>\nAcrocyanosis is functional peripheral<\/span> vascular<\/span> disorder characterized by dark mottled discoloration, or cyanosis<\/span>, of the hands, feet and sometimes the face.<\/p>\nAcrocyanosis is caused by the spasm of the small vessels in the skin in response to the cold. Can be primary<\/span> or secondary1,2<\/sup><\/p>\n<\/span>Who gets acrocyanosis?<\/span><\/h2>\nPrimary acrocyanosis occurs more frequently in adolescents and young adults (the onset is usually between 20 and 30 years old) 1,2<\/sup><\/p>\n\n- It is more common in women than in men.<\/li>\n
- Acrocyanosis is rarely seen in children or postmenopausal women.<\/li>\n
- May coexist with chilblains, erythromelalgia, or Raynaud's phenomenon<\/span>.<\/li>\n<\/ul>\n
Secondary acrocyanosis can occur at any age, depending on the underlying cause.<\/p>\n
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<\/span>What causes acrocyanosis?<\/span><\/h2>\nThe causes of acrocyanosis depend on whether it is primary or secondary.1\u20133<\/sup><\/p>\n<\/span>Primary acrocyanosis<\/span><\/h3>\nPrimary acrocyanosis is genetically determined or of unknown origin. Not associated with occlusive<\/span> arterial<\/span> disease. Chronic<\/span> small vasospasm cutaneous<\/span> arterioles<\/span> or venules<\/span> results in secondary dilation of capillaries<\/span> and the subpapillary venous<\/span> plexus.<\/p>\n<\/span>Secondary acrocyanosis<\/span><\/h3>\nFactors contributing to secondary acrocyanosis may include:<\/p>\n
\n- Hypoxemia, often due to lung disease or smoking\n<\/li>\n
- \nConnective tissue<\/span> diseases (eg, granulomatosis with polyangiitis, rheumatoid arthritis<\/span>lupus erythematosus overlay syndrome<\/span>)<\/li>\n
- \nNeoplasms<\/span> (for example, Hodgkin lymphoma<\/span>ovarian Cancer<\/span>)<\/li>\n
- Occlusive arterial diseases (peripheral vascular disease)<\/li>\n
- Eating disorders and malnutrition.\n<\/li>\n
- Hematological<\/span> disorders<\/li>\n
- Drugs and toxins<\/span>\n<\/li>\n
- Infections<\/li>\n
- Atopic<\/span> dermatitis<\/span><\/li>\n
- Hereditary diseases (eg, Mitochondrial disease, Down syndrome, Ehlers-Danlos syndrome)<\/li>\n
- Childhood<\/li>\n
- Buerger's disease<\/li>\n
- Spinal cable<\/span> injury<\/li>\n
- \nAtrophic<\/span> rhinitis<\/li>\n
- \nPsychiatric<\/span>\/ psychological reasons<\/li>\n<\/ul>\n
<\/span>What are the clinical features of acrocyanosis?<\/span><\/h2>\n<\/span>Primary acrocyanosis<\/span><\/h3>\nPrimary acrocyanosis is presented with bilateral<\/span>, symmetrical<\/span>Persistent, painless blue discoloration of fingers and toes. Acrocyanosis can be extended to include hands, feet, and face. Pressure on an area of pallor<\/span> leads to a slow and irregular return of blood from the periphery to the center (Crocq sign<\/span>) Arterial pulses are normal and there is no proximal<\/span> pallor<\/span>, ulceration<\/span> or gangrene<\/span>. 1,2,4<\/sup><\/p>\nThe clinical features of acrocyanosis may also include:<\/p>\n
\n- \nHyperhidrosis<\/span> hands and feet<\/li>\n
- Cold hands and feet<\/li>\n
- Swelling digits<\/span>\n<\/li>\n<\/ul>\n
<\/span>Secondary acrocyanosis<\/span><\/h3>\nThe presentation of secondary acrocyanosis varies depending on the underlying cause. Secondary acrocyanosis is often asymmetric<\/span> and it is associated with pain and tissue damage (blue toe syndrome).<\/p>\nSigns of a primary disorder may be present.<\/p>\n\n<\/span>Secondary acrocyanosis<\/span><\/h5>\n<\/section>\n\n\n
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Secondary acrocyanosis<\/p>\n
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Secondary acrocyanosis<\/p>\n
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Secondary acrocyanosis<\/p>\n<\/p><\/div>\n<\/section>\n
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<\/span>How is acrocyanosis diagnosed?<\/span><\/h2>\nThe clinical diagnosis of acrocyanosis is based on the general appearance of the patient and the distribution<\/span> and persistence of cyanosis.1,2,5<\/sup><\/p>\nIn young adults, where the diagnosis is most likely to be primary acrocyanosis, only limited research is required.<\/p>\n
In older adults, or if there is atypical<\/span> Features such as acrocyanosis pain and asymmetry will require specific background, examinations, and investigations to determine the cause. Investigations may include:<\/p>\n\n- Pulse oximetry<\/li>\n
- Urine analysis<\/li>\n
- Full blood count, C-reactive protein<\/span>, ESR<\/span>\n<\/li>\n
- Standard biochemistry that includes liver and kidney function.<\/li>\n
- Streptococcal titles<\/li>\n
- Autoantibodies<\/span><\/li>\n
- \nImmunoglobulins<\/span> and plasma<\/span> electrophoresis<\/span>\n<\/li>\n
- \nComplement<\/span> studies<\/li>\n
- Chest x-ray<\/li>\n
- Venous and arterial blood gas measurements<\/li>\n
- Skin biopsy<\/span><\/li>\n
- Nail fold capillaroscopy (to distinguish primary cyanosis from early-stage connective tissue disorders).<\/li>\n<\/ul>\n
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<\/span>What is the treatment for acrocyanosis?<\/span><\/h2>\n<\/span>Primary acrocyanosis<\/span><\/h3>\nTreatment is not required for most patients with acrocyanosis and pharmacological intervention is rarely necessary.1,5<\/sup> The patient should be assured that the condition is harmless. Options for active management can include:<\/p>\n\n- Behavioral measures, such as avoiding exposure to cold and trauma<\/span>\n<\/li>\n
- Psychophysiological measures, such as biofeedback training, reflex conditioning, and hypnosis.<\/li>\n<\/ul>\n
Note that vasodilators, for example calcium channel blockers, are not helpful (unlike Raynaud's phenomenon).<\/p>\n
\n- There is limited evidence of benefit of bioflavonoids, nicotinic acid derivatives, adrenergic blockers, current<\/span> minoxidil, cyclandelate, rutin compounds and bromocriptine.<\/li>\n
- \nSympathectomy<\/span> It can be considered in very severe cases.<\/li>\n<\/ul>\n
<\/span>Secondary acrocyanosis<\/span><\/h3>\nThe treatment of secondary acrocyanosis depends on the underlying cause.<\/p>\n
<\/span>What is the result of acrocyanosis?<\/span><\/h2>\nPrimary acrocyanosis is a benign<\/span> condition that usually resolves in middle age without long term aftermath<\/span>.<\/p>\nSecondary acrocyanosis can be resolved by treating the primary cause. As the pathological mechanisms that cause secondary acrocyanosis vary, so does forecast<\/span>.<\/p>\n<\/section>","protected":false},"excerpt":{"rendered":"\u00bfQu\u00e9 es la acrocianosis? La acrocianosis es funcional perif\u00e9rico vascular trastorno caracterizado por decoloraci\u00f3n moteada oscura, o cianosis, de las manos, los pies y, a veces, la cara. La acrocianosis…<\/p>","protected":false},"author":8,"featured_media":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","format":"standard","meta":{"footnotes":""},"categories":[204],"tags":[],"class_list":["post-6758","wiki","type-wiki","status-publish","format-standard","category-glosario-definiciones"],"_links":{"self":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/wiki\/6758","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/wiki"}],"about":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/types\/wiki"}],"author":[{"embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/comments?post=6758"}],"version-history":[{"count":0,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/wiki\/6758\/revisions"}],"wp:attachment":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/media?parent=6758"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/categories?post=6758"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/tags?post=6758"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}