Acrocyanosis: Symptoms, Causes & Treatment

What is acrocyanosis?

Acrocyanosis is a painless condition where the colour of our hand or feet turn bluish. This blue colour is due to a functional vascular condition in which the mucosa membrane causes discolouration due to oxyhemoglobin deficiency. In this condition, due to decreased blood flow, lesser oxygen reaches to the veins. It may be attributed to oxygenation defects of the central or local tissue.

The episodic pain condition is very rare, with the exception of necrotic variant, trophic changes and ulceration. It refers, by definition, to persistent abnormally deep-blue or cyanotic skin colour discoloration across ends (usually hand and feet).

 Acrocyanosis is usually normal in newborns. Acrocyanosis was discovered in 1896.  There are two categories of acrocyanosis- primary and secondary. Primary acrocyanosis occurs on both sides of the body, eg, if you have this condition on one hand, under primary acrocyanosis, it will occur on the other side as well. Primary acrocyanosis may also occur due to change in temperature (usually cold) or due to emotional stress. Though this condition is not considered harmful. 

On the other hand, secondary acrocyanosis occurs on one side. Secondary acrocyanosis may happen due to psychiatric illness, underlying disease, eating disorder or cancer.

Acrocyanosis symptoms-

In acrocyanosis, hands and feets being the extremities get affected the most. Other body parts such as nose, lips, ears, wrists, ankles, nipples may also show some symptoms. The symptoms will be visible on both sides in primary acrocyanosis. 

In secondary acrocyanosis, these marks may be painful as they are caused due to loss of tissue.

The common symptoms which can be experienced in acrocyanosis are-

  • Blue colour fingers and toes due to oxygen deficiency.
  • Hands and feet come damp, clamorous and sweaty.
  • Body temperature tends to decrease.
  • Blood flow is not smooth.
  • Hands and feet swell.
  • Normal pulse.

These symptoms tend to get even worse if the body is exposed to cold temperature, whereas the symptoms improve under a warmer temperature.  The blue colour even disappears where some movement is done with the hands or legs(where the acrocyanosis has occurred) as it allows blood to flow.

Acrocyanosis

Usually, a newborn has blue hands and feet, for a few hours after birth. This condition can also be witnessed when the baby takes a bath, but it does not last long in newborns.

Acrocyanosis causes

There could be different reasons for different kinds of acrocyanosis-

Primary acrocyanosis

 This condition happens due to decreased blood flow in the blood vessels resulting in lesser oxygen being able to reach the blood vessels. The main difference between primary and secondary acrocyanosis is that primary acrocyanosis can be seen on both sides of the body.

Primary acrocyanosis can happen due to the following reasons-

  • Being exposed to cold temperature
  • Genetically defective blood vessels
  • If one lives in a place which is at a high altitude, the oxygen level is usually low in such places and the wind is also comparatively cold. People living under such conditions may have a higher chance of having acrocyanosis.

Secondary acrocyanosis

The reason for the occurrence of secondary acrocyanosis is usually an underlying disease. It may include infections, tumours, genetic disorder, vascular disorder, blood disease or consumption of drugs.

Secondary acrocyanosis can happen due to the following-

  • Raynaud’s phenomenon is the most common underlying cause for the occurrence of acrocyanosis, which makes our hands, legs or other body parts turn blue.
  • People suffering from anorexia have higher a higher tendency of having acrocyanosis. As under this condition, due to the weight loss, the body’s heat regulation may be affected.
  •  Ergot alkaloid medications, which can contribute to acrocyanosis, used for treating migraines and headaches.
  • Acrocyanosis may be caused by mosquito-borne viral infect chikungunya.
  • Acrocyanosis occurs in up to 24% of people with cancer.

Acrocyanosis in newborns

When a baby is born, its hands and feet are usually blue and also cold when touched. This happens due to improper blood circulation and is not a result of freezing or heating sensation.

The hands and feet start getting pink and less cold when the baby gets warmer. As long as the lips and tongue are pink, there is no need to worry as such condition is common among newborn. Therefore it is suggested to cover a newborn baby to make it warm. The doctor suggests to put socks on the baby and to keep it wrapped with a warm cloth.

In case the lips and tongue turn purple, it may need medical attention as it is a sign of oxygen depletion in the blood vessels. Acrocyanosis is a newborn occurs due to vasomotor. Benign vasomotor changes contribute to peripheral vasoconstriction and increased extraction of tissues oxygen and are benign.

This condition is common in the newborn as some changes take place after being exposed to the natural environment from the womb.  This transition affects the blood circulation in the body.

Acrocyanosis treatment

There are two categories of acrocyanosis and involve different treatment.

Primary acrocyanosis

It is detected by the hands and feet, as they turn bluish. Sometimes the nose and ears are also affected by this condition. The doctor may also inquire about the medical history of the patient and the patient may be asked to undergo a physical examination.

The symptoms for primary acrocyanosis are-

  • Sweaty hands or feet.
  • Blue-coloured hands, feet, ears, lips etc.
  • One may also be able to experience cold hands and feet.
  • However, it is not painful.

Capillaroscopy, a noninvasive technique used by the doctor to measure the small vessels of the nail bed.  The doctor may also take certain tests for Raynaud’s syndrome, chilblains, which also results in blue hands and feet.

The doctor also checks the patient’s pulse rate, as a normal pulse indicates that the blue hands or feet are not a result of an artillery disease. Though there is no established treatment for acrocyanosis, a few clinical trials have proved to be beneficial in delivering the desired result. 

For newborns, the usual treatment is to keep the baby in a warm environment. If the condition is severe, medicines like an alpha-blocker and calcium channel blocker drugs, topical nicotinic acid derivatives, or minoxidil may be used to provide some relief.

Secondary acrocyanosis

In the case of secondary acrocyanosis, laboratory examination may be needed to determine underlying disease, if any. Secondary acrocyanosis may be serious as this condition arises due to some underlying disease. In such a condition, the doctor must be consulted immediately.

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