Acrocyanosis: The Flying Dutchman

This review summarizes existing knowledge regarding the demographics, pathology, diagnosis, and treatment of the condition

Andrew K Kurklinsky; Virginia M Miller; Thom W Rooke

2011

Scholarcy highlights

  • The term ‘acrocyanosis’ has been in use for over a century, yet the phenomenon remains poorly understood
  • This review summarizes existing knowledge regarding the demographics, pathology, diagnosis, and treatment of the condition
  • The term ‘acrocyanosis’ is commonly misused or is used liberally to describe other conditions that are characterized by peripheral cyanosis
  • The degree of confusion surrounding this phenomenon is well illustrated by a study of physicians with similar experience in the treatment of eating disorders that revealed poor interobserver correlation of detection of acrocyanosis in these patients
  • In cases of paraneoplastic acrocyanosis, small vessel thrombosis due to increased blood viscosity and proliferation of cellular elements may be responsible for the skin changes
  • In the setting of severe systemic illness requiring treatment with vasopressors, it may be difficult to single out the primary mechanism underlying acrocyanosis, when disseminated intravascular coagulation complicates the clinical picture
  • The prognostic significance of observed symptoms is not always clear and causes some clinicians to grow very guarded, while others, without assessing properly the clinical context, dismiss it altogether

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