[59F] Experiencing purple toes, small lumps on toes, itchy skin, and numbness in right hand

Patient Description

A 59-year-old female has been experiencing purplish discoloration on all toes of her right foot for the past 2-3 weeks, along with small, barely noticeable lumps on her toes present for about 2 weeks. Additionally, she reports itchy skin primarily on her back and numbness in her right hand, which has been occurring for about a week. The numbness is described as a loss of feeling without any noted improvement from specific actions. The patient has a medical history of high blood pressure diagnosed 2 years ago and stage 3 chronic kidney disease diagnosed 6 months ago. She is currently taking 10mg of Lexapro daily for anxiety, 10mg of Lisinopril daily for high blood pressure, and 10mg of Dicyclomine daily for IBS. No recent injuries or trauma were reported, and there have been no changes in the temperature or color of the affected foot compared to the unaffected foot. The patient denies any family history of cardiovascular disease or other circulatory problems.

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Arora's Assessment

What might be happening

Based on the information you have provided, possible causes include:

  • Peripheral Artery Disease (PAD): This is a condition where the blood vessels in the legs are narrowed or blocked, reducing blood flow to your legs and feet. PAD can cause color changes in the skin, pain, and numbness. It is more common in people with high blood pressure and chronic kidney disease.

    • Treatment often involves lifestyle changes, such as quitting smoking, eating a healthy diet, and getting regular exercise. Medications to control blood pressure and cholesterol levels may also be prescribed.
  • Raynaud's Disease: This is a condition that causes some areas of your body, like your fingers and toes, to feel numb and cold in response to cold temperatures or stress. The skin may turn white or blue, then flush red as it warms up.

    • Treatment often involves avoiding triggers, such as cold temperatures and stress. Medications to improve blood flow may also be prescribed.
  • Chilblains (Pernio): This is a condition that can cause itching, red patches, swelling, and blistering on your hands and feet. It often occurs after exposure to cold, damp conditions.

    • Treatment often involves protecting the skin from the cold, using lotions to soothe the skin, and medications to improve circulation.

What you can do

It would be best to consult a doctor about your symptoms so that they can provide a formal assessment and order relevant tests if necessary. In the meantime, you can try the following to relieve your symptoms:

  1. Keep your feet warm and dry. Avoid exposure to cold, damp conditions.
  2. If you smoke, try to quit. Smoking can worsen circulation problems.
  3. Try to manage your stress levels. Stress can trigger Raynaud's symptoms.
  4. Continue taking your prescribed medications as directed by your doctor.

What you should look out for

Reasons to see a doctor more urgently:

  • If your symptoms worsen or do not improve
  • If you develop severe pain in your feet or legs
  • If you notice sores or ulcers on your feet that are not healing
  • If you develop other symptoms, such as chest pain or shortness of breath

Please remember that while I strive to provide accurate and helpful health information, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care recommendations.

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8 mo ago

People Also Ask


What causes purplish discoloration in toes?

Purplish discoloration in toes can be caused by reduced blood flow, which may be due to conditions like Peripheral Artery Disease (PAD), Raynaud's Disease, or Chilblains. It is important to consult a healthcare provider for an accurate diagnosis.


How can high blood pressure affect circulation in the feet?

High blood pressure can damage blood vessels over time, leading to reduced blood flow and circulation issues in the extremities, such as the feet. This can result in symptoms like discoloration, numbness, or pain.


What are the symptoms of Peripheral Artery Disease (PAD)?

Symptoms of Peripheral Artery Disease (PAD) include leg pain when walking, purplish or bluish discoloration of the skin, numbness, weakness, and sores or wounds on the feet that do not heal well. It is important to seek medical advice if these symptoms occur.


How can Raynaud's Disease be managed?

Raynaud's Disease can be managed by avoiding triggers such as cold temperatures and stress, keeping the body warm, and sometimes using medications to improve blood flow. Lifestyle changes and stress management techniques can also be beneficial.


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