BLUE DIGIT SYNDROME AS THE INITIAL PRESENTATION OF VARIOUS DISEASES: A CASE SERIES
Authors: García R et al.
In this cohort study from Spain patients with blue digit syndrome (BDS), who were referred to a university departement of rheumatology between 2017 and 2022, are described and characterised.
Blue Digit Syndrome (BDS) represents the cutaneous manifestation of numerous diseases that cause blue discoloration in one or more fingers in the absence of trauma and with preserved pulses. The diagnosis of the underlying cause is crucial to treat the underlying disease. While it may not be the most common etiology, many systemic autoimmune and inflammatory diseases can present with cutaneous manifestations such as BDS. Being sometimes the only exploratory finding, diagnosis may be challenging.
Forty-five patients (20 males and 25 females) were included with a mean age of 56.4 years. 46.7% were smokers. 48.9% had cardiovascular risk factors. The most frequent diagnoses were thrombangiitis obliterans (TAO) (22.2%), systemic sclerosis (SSc) (15.6%), severe atherosclerosis (8.9%), haematological disorder (8.9%) and cryoglobulinemia (8.9%). 10% of cases were considered idiopathic. 28.9% of patients had systemic symptoms. Examinations included autoimmunity tests, echocardiogram, arteriography, blood analysis among others. Skin biopsies were performed in 13 out of 40 patients, of which 2 out of 13 showed diagnostic findings of cholesterol emboli, 1 out of 13 showed calciphylaxis, 1 out of 13 showed vasculitis. 56% of the cases resolved with medical treatment. 8 patients (17.8) required surgical amputation of the affected finger.
This case series from Spain showed that patients with Blue Digit Syndrome had a variety of different underlying diagnosis. Most of the patients referred with this syndrome had thrombangiitis obliterans or systemic sclerosis.
In this abstract it is unfortunately not mentioned whether the patients had isolated blue digit syndrome and not a Raynaud’s phenomenon.