What is an Acrocyanosis?

March 22 20:12 2019 Print This Article

It is defined as a condition in which there is a blue discoloration of the digits. It involves the hands mainly. It is persistent in the nature. It may occur on the face and feet as well. The discoloration can be cyanotic also. It is mainly a benign cosmetic condition. It may also become a benign neuro hormonal disorder. The benign form does not need any treatment. If the extremities experience a prolonged exposure of cold it may lead to the medical emergency. It occurs mainly in the children and in the patients with ill health. This condition differs from the frost bite as it is associated with the pain via thermal nociceptors while this disorder is rarely associated with the pain. It is a serious and a medical problem which includes the connective tissue diseases and the disorders associated with the central cyanosis.

What are the signs and symptoms of the Acrocyanosis?

It includes the peripheral cyanosis, consistent cyanosis present in the hands, feet or face. The extremities are cold and clammy and may have some swelling. There is a wide range of sweating seen in the palms and soles. It can be moderate to profuse and all peripheral pulses are normal in the rate, rhythm and quality. The cyanosis gets worse when the patient is exposed to the cold conditions. It improves during the hot weather. The patient does not show any symptoms and there is no pain associated with it. The most common sign is the discoloration which motivates the patient to look for a better medical care.

What are the incidence, epidemiology and prevalence of Acrocyanosis?

There is no data to confirm the incidence of this disorder. However, the prevalence is more in the young children and adults which are below the age of 30 than those which are above the age of 30. The risk factors associated with this disorder are the cold climate, outdoor occupation and a low body mass index. It is more prevalent in women as compared to the men. It is mainly attributed to the low body mass index in women. The incidence rate decreases with the increasing age and does not depend on the climate of that area.

What is the patho physiology of Acrocyanosis?

The etiology of this condition is not known. Some authors relate it to the vasospasms present in the skin arteries and arterioles. They produce a cyanotic discoloration and the compensatory dilation in the post capillary sphincter creates a sweating. There is a local hypoxic environment created by the persistent vaso constriction at the pre capillary sphincter. It releases an adenosine in the capillary bed. It is forced by the vasospasm. It vaso dilates the post capillary venules. The difference in the vessel tone creates a counter current exchange system which retains the heat. It may lead to the profuse sweating. The adenosine and other hormones may also increase the blood levels of serotonin. It supports the case studies related to the side effects in case of pediatric patients who suffer from this disorder and take tri cyclic anti depressants’ which stops the intake of serotonin and increases the blood levels.

What is the diagnosis of Acrocyanosis?

It is mainly done with the help of complete medical history and physical examination. It does not require the use of laboratory and imaging studies. There are normal peripheral pulses which rule out the peripheral arterial occlusive disease in which the arterial narrows the limits of blood flow to the extremities. The normal oxygen saturation is seen by the pulse oximetry. The cyanosis is consistently present and the Reynaud’s phenomenon is not present persistently. In the Reynaud’s phenomenon there is no skin change along with the pain or ulcer formation.

What is the prognosis of Acrocyanosis?

There is no specific treatment for this disorder but they have an excellent prognosis. If the condition is benign the risk of getting infected is less and there are no complications. Other than discoloration there are no other symptoms like no pain or no loss of function. The patient normally lives a routine life. This disorder is common in the pre term and full birth babies. No intervention is required but hospitals may provide additional oxygen for precautionary measures.

What is the treatment of Acrocyanosis?

There is no specific treatment for this disorder. One can look for reassurance and must avoid the cold stuff. He must be reassured that this is not an emergency condition. The cyanosis can be increased by the symphathectomy which disrupts the fibers of sympathetic nervous system. It is done in very rare conditions. The same effect can be seen by the alpha adrenergic blocking agents or calcium channel blockers.

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