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Has anyone ever seen purple nails before?? I had a diabetic pt with a purple tinge to all of her nails, who reported no nail polish and had circulation within normal limits.

Please help????

When you say that circulation was within normal limits, was this an examination of the macrovascular structures (ie Doppler, ABI) only? There is a good chance there is microvascular disease of the smaller vessels, especially around the arteriovenous plexus region, which could account for the poor perfusion of the nail bed. Are there any signs of vasculitis or vasospastic disorders?

cheers,

Felicity

Felicity bet me to it .... plain old PVD can cause a 'purple' tinge to the nails

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Craig Payne
Department of Podiatry
La Trobe University
Melbourne, Australia
http://www.latrobe.edu.au/podiatry
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God put me on this earth to accomplish a certain number of things - right now I am so far behind, I will never die.
The views expressed above are those of the author and not that of La Trobe University
This is where I am, where are you?

Flick and Craig,

Yes I did only test the macro vessels (palpation, Doppler etc). There are no signs of any vasculitis or vasospastic disorders. Capillary refill was also WNL. This pt was quite worried that she was going to lose her limbs due to her circulation deficiency. Visual signs were all good (hair growth, nail growth). So is it just the nail bed that is affected??

I would biopsy the nails to be sure.Ask about the rest of general health as well.

Hi all, call me simple (yeah, OK, thanks!), but have you eliminated physical non - systemics such as shoe dye, foot 'soaks' with pot' permanganate and the use of henna, (which is popular as a hand and foot 'hardner' in some cultures) There are some interesting illustrations of similar phenomena in ' a colour atlas of the foot in clinical diagnosis' (zatouroff & Bouffler 1992 ISBN 0 7234 0813 0) Regards, Martin

Martin:You made a GREAT point.I did not think about the possibility of the horseinfront of me....I was looking for the zebra!

Thanks John, if you need simple then i'm your man. In fact, after a couple of glasses of the falling waters (taken purely for their cardio-tonic effect you understand) I can reach such depths of simplicity that I am overcome by their complexity and have to be led into a darkened room, to lie in the trendelenberg position while I ponder how many polysyllabic anagrams which are antonyms of antidisestablishmentaraianism I can construct from the words Root, Orien and Weed. This is very relaxing. It does, however, disturb my Patients - is this normal?

Trust me....there is no one more simple than I.