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What causes purplish discoloration in legs and toes while sitting for few minutes?

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Posted on Tue, 19 Jul 2016
Question: When I sit down or stand still for a couple of minutes, my toes go red and sometimes purple-ish. It goes back to normal when I walk or when I elevate my legs. I was scared of possible (seceondary) acrocyanosis as I had couple of episodes of having brief attacks of purplish discoloration in my fingers in colder tempearture, but it was never a persistent blueness nor the characteristic Raynaud color changes. My vascular specialist ruled out acrocyanosis. He believes it's more of blood pooling in my feet due to venous insufficiency (classified CEAP C1,C2,C4a after an examination) and I was advised to wear compression stockings. I just want to make sure if that's the case.
doctor
Answered by Dr. T Chandrakant (1 hour later)
Brief Answer:
Not acrocyanosis. Obesity and varicose veins contribute.

Detailed Answer:
Hi.
Thanks for your query.
To recapitulate: Male/32 - formerly *very obese man - toes go red or purplish sit down or stand still for couple of minutes - back to normal on walking or elevating the legs - scared of possible secondary acrocyanosis - has couple of attacks of purplish discoloration in colder temp - Vascular Specialist ruled out acrocyanosis - thinks of CEAP C1, C2, C4a - advised to wear compression stockings - consulted Doctors/Vascular Specialists - 3 say of venous insufficiency - seen pictures of today - just want to make sure ...

Please give some additional information:
- Since when have you started getting this problem?
- Your height and weight to know the BMI.
- Please post the reports of any investigations that might have been done till now.

My thoughts after reading your history and correlating some points with the
pictures you have provided:
This is surely not acrocyanosis as the cyanosis is permanent in acrocyanosis which is not there in your case.
Obesity is one of the reasons of such vascular responses.
One of the important reasons in obesity and having such responses is varicose veins with competent valves, hence walking helps to get the normal skin as the calf muscles also called as venous pump becomes active and help in emptying the venous stasis and improves the normal blood circulation.

I hope some of these investigations must have already been done:
Vascular color doppler of the lower limbs.
Tests of the blood including routine CBC, liver, kidney, thyroid and other functions to make sure that they are within normal limits.

Reducing obesity can help you a lot.

I hope this answers your query, please feel free to ask for further relevant queries if you feel that there is a gap of communication.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant (21 minutes later)
Thank You Doctor, I noticed that in May, but I may as well have it for a long time. I currently weigh 108 kg (238 pounds, BMI 33). Sep 2015 - 138 kg (304 pounds, BMI 43). I have total blood count and liver enzymes within normal limits
doctor
Answered by Dr. T Chandrakant (18 minutes later)
Brief Answer:
Please get the venous color doppler

Detailed Answer:
Thanks for your feedback.
Even a BMI of 33 can be a contributory factor. Try to reduce it further.
Please get the Vascular color doppler particularly for the venous system of both the lower limb as it may add to the treatment.
Continue to wear compression stockings.
Keep the lower limbs in elevated position whenever possible like resting at home .

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. T Chandrakant

General Surgeon

Practicing since :1984

Answered : 18097 Questions

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What causes purplish discoloration in legs and toes while sitting for few minutes?

Brief Answer: Not acrocyanosis. Obesity and varicose veins contribute. Detailed Answer: Hi. Thanks for your query. To recapitulate: Male/32 - formerly *very obese man - toes go red or purplish sit down or stand still for couple of minutes - back to normal on walking or elevating the legs - scared of possible secondary acrocyanosis - has couple of attacks of purplish discoloration in colder temp - Vascular Specialist ruled out acrocyanosis - thinks of CEAP C1, C2, C4a - advised to wear compression stockings - consulted Doctors/Vascular Specialists - 3 say of venous insufficiency - seen pictures of today - just want to make sure ... Please give some additional information: - Since when have you started getting this problem? - Your height and weight to know the BMI. - Please post the reports of any investigations that might have been done till now. My thoughts after reading your history and correlating some points with the pictures you have provided: This is surely not acrocyanosis as the cyanosis is permanent in acrocyanosis which is not there in your case. Obesity is one of the reasons of such vascular responses. One of the important reasons in obesity and having such responses is varicose veins with competent valves, hence walking helps to get the normal skin as the calf muscles also called as venous pump becomes active and help in emptying the venous stasis and improves the normal blood circulation. I hope some of these investigations must have already been done: Vascular color doppler of the lower limbs. Tests of the blood including routine CBC, liver, kidney, thyroid and other functions to make sure that they are within normal limits. Reducing obesity can help you a lot. I hope this answers your query, please feel free to ask for further relevant queries if you feel that there is a gap of communication.