The abrupt development of cyanotic and painful toes, "the blue toe syndrome," has been attributed to a number of medical conditions. We describe a patient in which the workup for this condition failed to elucidate a typical cause. Skin biopsy, serologic findings, and response to treatment led to the diagnosis of secondary syphilis. Our experience indicates that secondary syphilis should be included in the differential diagnosis of patients presenting with the blue toe syndrome.
(Arch Intern Med. 1994;154:1029-1031)