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Blanching of the fingers

BJan 17 05

Alternative names 
Fingers that change color

Definition
Fingers that turn pale or turn colors when exposed to cold or stress is an indication of cyanosis. Blanching means to become pale. Cyanosis is a bluish discoloration of the skin and mucous membranes from lack of oxygen.

Considerations
Raynaud’s Disease or syndrome may cause sudden change in the finger color.

Common Causes

     
  • Arterial insufficiency or spasms of arteries that supply blood to the fingers and toes  
  • Systemic lupus erythematosus  
  • Necrotizing vasculitis  
  • Scleroderma

Home Care
Avoid smoking.

Avoid exposure to cold in any form. Wear mittens or gloves outdoors and when handling ice or frozen food. Avoid chilling, which may happen following any active recreational sport. Wear comfortable, roomy shoes and wool socks. When outside, always wear shoes.

Call your health care provider if

     
  • Fingers change color and the cause is not known.  
  • Fingers or toes turn black or the skin breaks.

What to expect at your health care provider’s office
The medical history will be obtained and a physical examination performed.

Medical history questions documenting change in finger color in detail may include:

     
  • Time pattern       o Did the fingers suddenly change color?       o Has the color change occurred before?  
  • Aggravating factors       o Does cold or emotion cause the fingers to turn white (blanching)?       o Does cold or emotion cause the fingers to turn blue (cyanosis)?  
  • Quality       o Do fingers turn red?       o Do they turn blue?       o Do they turn white?       o Do they look black or gray?  
  • Aggravating factors       o Did this occur after anesthesia?       o Do you smoke?  
  • other       o What other symptoms are also present?       o Is there finger pain?       o Is there arm pain?       o Is there a change in the texture of the skin?       o Is there loss of hair on the arm or hands?

The physical examination will include thorough examination of the hands, arms, and fingers.

Diagnostic tests that may be performed include:

     
  • Blood studies (such as CBC or blood differential)  
  • X-ray of the hands and feet

Intervention:
Use of drugs to dilate small arteries and improve circulation may be prescribed. Surgery to cut the sympathetic nerves to the affected extremities (for Raynaud’s phenomenon) is an option that may relieve symptoms for 1 or 2 years before they recur.

After seeing your health care provider:
You may want to add a diagnosis related to change in finger color to your personal medical record.

Johns Hopkins patient information

Last revised: December 8, 2007
by Armen E. Martirosyan, M.D.

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All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.
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