1997 Volume 59 Issue 5 Pages 675-677
A case of a 68-year-old male with blue toe syndrome is reported. He first noticed painful blue toe after undergoing percutaneous transluminal coronary angioplasty (PTCA) 6 months previously. After undergoing coronary angiography (CAG), fever, myalgia on his legs, blue toe and livedo reticularis all appeared on his trunk and extremities. Histopathologically, cholesterol clefts surrounded by fibrin thrombus were recognized in the arterial lumen at the junction of the dermis and the subcutaneous fat. The same histological appearance was also observed in the kidney. Multiple cholesterol emboli were seen and probably originated from the atheromatous plaques in the aorta ascendens. LDL apheresis may thus be effective for the treatment of eruptions and renal failure. A skin biopsy was also found to be effective for making an accurate diagnosis of blue toe syndrome.
