A 43-Year-Old With Painful, Discolored Toes

Colin C. Edgerton, MD


October 04, 2023

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A 43-year-old woman presents to the rheumatology clinic with a 1-month history of painful, discolored toes. She first noted redness and itching at the tips of her toes about 2 months before presentation. The itching progressed to tenderness, followed by the formation of "sores" over the affected areas. She notes that the toes have been sensitive to cold, particularly when she leaves the house and is exposed to winter weather. She has not had any trauma to her feet, recent illnesses, or recent surgical interventions.

The patient has never had similar symptoms in the past. She feels otherwise well and has not had any fever, joint pain, gastrointestinal symptoms, or weight changes. Her current medications include over-the-counter fish oil tablets and a daily multivitamin. She does not smoke tobacco and drinks three glasses of wine weekly.


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