Acrocyanosis: the Flying Dutchman

Vasc Med. 2011 Aug;16(4):288-301. doi: 10.1177/1358863X11398519. Epub 2011 Mar 22.


Acrocyanosis is symmetric, painless, discoloration of different shades of blue in the distal parts of the body that is marked by symmetry, relative persistence of the skin color changes with aggravation by cold exposure, and frequent association with local hyperhidrosis of hands and feet. Described over a century ago and despite seeming familiarity, it remains a poorly understood condition that shares much in clinical presentation with other conditions characterized by skin color changes in the distal parts of the body. The diagnosis remains mostly clinical, and pathological mechanisms vary suggesting that acrocyanosis may not be a single entity. We performed an extensive literature review to summarize existing knowledge about the demographics, pathology, diagnosis, and treatment of this condition.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Cyanosis* / diagnosis
  • Cyanosis* / epidemiology
  • Cyanosis* / physiopathology
  • Cyanosis* / therapy
  • Humans
  • Lower Extremity / blood supply*
  • Predictive Value of Tests
  • Regional Blood Flow
  • Risk Factors
  • Treatment Outcome
  • Upper Extremity / blood supply*