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What Causes Purple Toes And Crusty Raised Nail Beds?

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Posted on Thu, 25 May 2023
Question: my feet and legs have been bothering me for quite awhile now, but now my toes are kind of purple on the tips in and around the nail. The nail bed is raised a little with a crusty white dry substance under the tips of the nail. My feet are always cold but sweat too. Can you help? Thank you XXXX
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Answered by Dr. Lekshmi Rita Venugopal (3 hours later)
Brief Answer:
Possible diagnosis: Peripheral vascular (arterial) disease

Detailed Answer:

Hello,

The leg pain especially in walking, purple discoloration of toes, cold feeling are all suggestive of possible underlying peripheral artery disease (PAD). PAD occurs due to atherosclerotic changes causing decreased blood flow through arteries supplying the legs. The only symptom that you mentioned that is not very typical of PAD is sweating. However, the presence of sweating cannot exclude PAD in presence of the other symptoms you are experiencing.

Physical examination, ankle brachial index analysis can confirm the diagnosis. If the ankle-brachial index is abnormal, CT angiogram to get a detailed look at the arteries will be taken.

Management is mainly through exercise, smoking cessation if you do so, weight reduction if needed, adequate control of lipids with statins and anti-platelet medication like Aspirin.

Please be advised to follow up with your primary care provider for further evaluation and management.

Hope this answers your question.

Regards,
Dr. Lekshmi Rita Venugopal
General & Family Physician
Note: For further inquiries on surgery procedure and its risks or complications book an appointment now

Above answer was peer-reviewed by : Dr. Arnab Banerjee
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Answered by
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Dr. Lekshmi Rita Venugopal

General & Family Physician

Practicing since :2012

Answered : 3808 Questions

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What Causes Purple Toes And Crusty Raised Nail Beds?

Brief Answer: Possible diagnosis: Peripheral vascular (arterial) disease Detailed Answer: Hello, The leg pain especially in walking, purple discoloration of toes, cold feeling are all suggestive of possible underlying peripheral artery disease (PAD). PAD occurs due to atherosclerotic changes causing decreased blood flow through arteries supplying the legs. The only symptom that you mentioned that is not very typical of PAD is sweating. However, the presence of sweating cannot exclude PAD in presence of the other symptoms you are experiencing. Physical examination, ankle brachial index analysis can confirm the diagnosis. If the ankle-brachial index is abnormal, CT angiogram to get a detailed look at the arteries will be taken. Management is mainly through exercise, smoking cessation if you do so, weight reduction if needed, adequate control of lipids with statins and anti-platelet medication like Aspirin. Please be advised to follow up with your primary care provider for further evaluation and management. Hope this answers your question. Regards, Dr. Lekshmi Rita Venugopal General & Family Physician