The non-ischaemic blue finger

Finger discoloration may result from recognized conditions affecting upper limb vasculature. We describe 11 patients who presented with acute pain, sw elling and blue/purple discoloration in a finger. This benign condition mim icked digital ischaemia. There were 9 women and 2 men. The episode usually started with an ache/pain in the finger followed 2-3 h later by a blue/purp le discoloration primarily on the volar aspect but always sparing the tip. This completely resolved after 4-7 days with no residual deficit. There was no history of trauma. Four patients had had previous episodes - 2 had been started on warfarin. There was no family history and only one gave a histo ry of spontaneous bruising of her legs. Examination of all patients - pulse rate, blood pressure, cardiac and subclavian artery auscultation and digit al artery Doppler insonation - was normal. All patients had normal full blo od counts, CRP, vasculitis screen and clotting (except those on warfarin). Six similar cases, all women, were reported in 1982. There was no common ae tiological factor other than sex. Although of no prognostic significance, t he condition is likely to concern patients and doctors in primary care. The discoloration is, however, clearly of a different distribution to that in an ischaemic finger where the tip of the digit is involved.