Pulmonary Embolism Support Group

Call your doctor right away....it could be purple toe syndrome starting.....I think that this is urgent or an emergency.

I was wondering about that but what I read says it mostly starts within a few weeks of starting meds. Guess it could happen anytime though. Will call and see.

If I recall, I think TossNTurn had something similar but it wasn't purple toe syndrome. But I agree, see your doc as a precaution.

Is it purple or reddy purple? I have reddish spots over both of my feet, I also get them on my eyes when I retch. The nurse said it was petechiae caused by the warfarin.

As the others have said though, best to get it checked out.

"A number of other medical conditions can cause purple toes and need to be considered by the treating physician."

Many other things cause it. But perhaps it might just be a simple bruise?

Only FYI and not to scare anyone----and yes, the doctor should be consulted.

From clotconnect

Causes of Blue Toe Syndrome
A. DECREASED ARTERIAL FLOW
Embolism
• Atheroemboli
o Occurring on “blood thinners (warfarin, heparin)
o after surgery and vascular instrumentation (cardiac cath)
• Cardiac or aortic tumor
o Myxoma
o Intimal aortic angiosarcoma
• Cardiac vegetations
o Infective endocarditis
o Nonbacterial thrombotic endocarditis
Thrombosis
• Antiphospholipid syndrome
• Malignancy (paraneoplastic acral vascular syndrome)
• Thrombotic thrombocytopenic purpura
• Disseminated intravascular coagulation
• Warfarin skin necrosis
Vasoconstrictive disorders
• Acrocyanosis
• Perniosis
• Chilblain lupus erythematosus
• Medication-induced vasoconstriction
Infectious and noninfectious inflammation
• Syphilis
• Pyogenic infection
• Behcet’s disease
• Other forms of vasculitis
Other vascular obstruction
• Calcific vasculopathy (‘‘calciphylaxis’’)
B. IMPAIRED VENOUS OUTFLOW
• Extensive venous thrombosis
C. ABNORMAL CIRCULATING BLOOD
Paraproteinemia with hyperviscosity
• Myeloproliferative disorders
• Polycythemia vera
• Essential thrombocythemia
Abnormal blood proteins
• Cryofibrinogenemia
• Cryoglobulinemia
• Cold agglutinins
Table modified after Hirschmann JV et al. Blue (or purple) toe syndrome. J Am Acad Dermatol.
2009 Jan;60(1):1-20.

Yeah, I had painful little spots all over three different toes on both feet back in January-Febraury. Tiny spots, but definitely reddish/purple and painful/sensitive sometimes. My doc thought it might be purple toe (even though I had been on warfarin two years at that point) but we kept an eye on them and nothing seemed to happen. I did see a vascular guy who thought I might be throwing arterial clots that were getting stuck in the capillaries in my toes, but that turned out to not be the case either.

Purple toe usually starts pretty quickly after starting warfarin. The latest a case ever showed up was after one year. I think it is possible for it to show up if you've gone off briefly for surgery too, but otherwise, it is a pretty slim possibility.

Actually, we never did figure out what they were. They disappeared after a couple of months and have never come back. Hope yours are nothing major either!

The doctor's office called and said it is probably bruising so we will see-looks kind of purple.

Let's hope Occam's Razor wins again!

Good luck.