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A venous lake (also known as phlebectasis [1]) is a generally solitary, soft, compressible, dark blue to violaceous, 0.2- to 1-cm papule commonly found on sun-exposed surfaces of the vermilion border of the lip, face and ears. [2] [3] [4] Lesions generally occur among the elderly. [5] [6]
Furthermore, mongolian spots, large birthmarks, and the consumption of food products with blue or purple dyes can also result in the bluish skin tissue discoloration and may be mistaken for cyanosis. [ 2 ] [ 3 ] Appropriate physical examination and history taking is a crucial part to diagnose cyanosis.
There are also a number of other conditions that affect hands, feet, and parts of the face with associated skin color changes that need to be differentiated from acrocyanosis: Raynaud phenomenon, pernio, acrorygosis, erythromelalgia, and blue finger syndrome. The diagnosis may be challenging in some cases, especially when these syndromes co-exist.
Methemoglobinemia, or methaemoglobinaemia, is a condition of elevated methemoglobin in the blood. [2] Symptoms may include headache, dizziness, shortness of breath, nausea, poor muscle coordination, and blue-colored skin (cyanosis). [2]
Livedo reticularis is a common skin finding consisting of a mottled reticulated vascular pattern that appears as a lace-like purplish discoloration of the skin. [1] The discoloration is caused by reduction in blood flow through the arterioles that supply the cutaneous capillaries, resulting in deoxygenated blood showing as blue discoloration ().
Both of these conditions cause cyanosis, or a bluish discoloration of skin or mucous membranes. [4] Normally, oxygenated blood appears red and deoxygenated blood has more of a blue appearance. [5] In babies with low levels of oxygen or mixing of oxygenated and deoxygenated blood, the blood can have a blue or purple color, causing cyanosis. [6]
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Mongolian spot is a congenital developmental condition—that is, one existing from birth—exclusively involving the skin.The blue colour is caused by melanocytes, melanin-containing cells, that are usually located in the surface of the skin (the epidermis), but are in the deeper region (the dermis) in the location of the spot. [6]