Acrocyanosis is an uncommon vasospastic disorder characterized by persistent cyanosis of the hands and feet and, to a lesser degree, the forearms and legs. It is associated with arteriolar vasoconstriction combined with dilation of the subcapillary venous plexus of the skin, through which deoxygenated blood slowly circulates. It is worse in cold weather but does not completely disappear during the warm season. It occurs primarily in women, is most common in the teens and twenties, and may improve with advancing age or during pregnancy. It is characterized by symmetric coldness, sweating, slight edema, and cyanotic discoloration of the hands or feet. Peripheral pulses are normal, and pain, trophic lesions, and disability do not occur.

Poszepczynska-Guigne E et al: Paraneoplastic acral vascular syndrome: epidemiologic features, clinical manifestations, and disease sequelae. J Am Acad Dermatol 2002;47:47.