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The Solitary Blue Toe: A Unique Presentation of Antiphospholipid Syndrome

Devin G. Dimond St. Mary's Medical Center, San Francisco, CA.

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Jenny K. Lam St. Mary's Medical Center, San Francisco, CA.

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Lauren Wurster St. Mary's Medical Center, San Francisco, CA.

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Christopher Kiser Samuel Merritt University, Oakland, CA.

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Kevin Driscoll Samuel Merritt University, Oakland, CA.

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Mark Razzante Saint Vincent Charity Medical Center, Cleveland, OH.

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Antiphospholipid syndrome is an autoimmune disease characterized by vascular thrombosis involving both the arterial and venous systems that can lead to tissue ischemia or end-organ damage. Much of the literature describes various symptoms at initial presentation, but isolated tissue ischemia manifesting as a solitary blue toe is unusual. We discuss a case of a 23-year-old man who presented to the emergency department with a solitary blue fourth digit with minimal erythema and edema, who was suffering from exquisite pain. Following an extensive workup, the patient was diagnosed with antiphospholipid syndrome with thrombi of the vasculature in their lower extremity. With therapeutic anticoagulation, the patient's symptoms subsided and amputation of the digit was prevented.

Corresponding author: Devin G. Dimond, DPM, St. Mary's Medical Center, 450 Stanyan St, San Francisco, CA 94117. (E-mail: devin.g.dimond@gmail.com)