Síndrome del dedo azul: de la piel a lo multisistémico

Abstract

El signo del dedo azul (SDA) es una condición poco frecuente causada principalmente por la oclusión de la vasculatura periférica. Clínicamente puede manifestarse como una coloración azulada o eritrocianótica en uno o varios dedos en ausencia de traumatismo y condiciones propias de congelación. Las etiologías son múltiples e incluyen obstrucción del flujo arterial, disminución del flujo venoso y alteración en la viscosidad sanguínea. La importancia de reconocer el signo como motivo de consulta radica en encaminar un diagnóstico temprano e instaurar un tratamiento que evite la evolución natural de la enfermedad hacia la necrosis, amputación o muerte del paciente. Proponemos un algoritmo diagnóstico para reconocer los elementos de la historia clínica que guíen la etiología y los paraclínicos disponibles desde el Servicio de Urgencias.

Cardiac Myxomas As Chameleons: A Scoping Review of Their Paraneoplastic Presentations

“…Some articles suggest grouping PS by the nature of the symptoms they experience, whether they are arthritic, hematologic, neurologic, respiratory, gastrointestinal, or dermatologic. The most common events include constitutional symptoms at 45-50%, hematological effects at 20-25%, and vasculitis/vasculopathy effects at 12% of cases, the latter even describing embolic events as being part of a "blue digit syndrome" [ 4 , 19 , 20 ]. Some uncommon manifestations associated with CMs include asthma, chorea, acute pancreatitis, iridocyclitis, worsening of systemic lupus erythematosus (SLE), and antiphospholipid antibodies [ 4 ].…”

Blue toe syndrome

“…There are many causes for this syndrome ( Table 1 ) 1 - 5 . It is essential to carry out an early diagnosis and start a therapy that prevents the natural evolution of the disease towards necrosis, amputation or the patient’s death 2 , 4 .…”

“…Two bullous lesions also appeared on the internal lateral side of the toe that later changed into necrotic patches. The patient was referred to the dermatologist, who gave a diagnosis of blue toe syndrome on 03/03/23 and referred the patient to vascular surgery to rule out the possibility of thromboangiitis obliterans (non-atherosclerotic inflammatory disorder that usually affects small and medium arteries, and is associated with the formation of inflammatory occlusive thrombi that cause ischaemia of extremities and digital necrosis; it often occurs in young men between 20 and 40 years of age, and is closely related to tobacco consumption 4 ).…”