• S Vignes, C Fourgeaud, and U Michon-Pasturel.
• Unité de Lymphologie, Centre national de référence des maladies vasculaires rares (lymphœdème primaire, malformations lymphatiques), hôpital Cognacq-Jay, 15, rue Eugène Millon, 75015 Paris, France. Electronic address: stephane.vignes@cognacq-jay.fr.
• Rev Med Interne. 2022 Sep 1; 43 (9): 562-565.

IntroductionCutaneous and vascular manifestations of cancer are numerous. Among paraneoplastic acral vascular syndrome, we report a case of blue toe syndrome as the first manifestation of a prostate cancer following with analysis of this syndrome according literature.ObservationA 56-year-old man, with Raynaud's phenomenon of the upper limbs for 2 to 3 years, had 4 blue toes of the left foot evolving for 18 months, without ulceration, the pulses being present. Vascular and cardiac explorations (ultrasound, angio-MRI) were normal. There was no biological or immunological abnormality except an elevated PSA level. Prostate biopsies confirmed diagnosis and abdomino-pelvic CT scan proved the bone and lymph node metastasis.ConclusionThe revelation of a prostate cancer with bone metastases by a blue toe syndrome is a rare situation. In a patient with a blue toe syndrome with no obvious clinical or biological abnormality, especially atheromatous, investigations should include a search for cancer, which can be revealed by blue toes.Copyright © 2022 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier Masson SAS. All rights reserved.

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