purple spot on both big toes. Been there 7 months

[oceanbreeze4987]

Ok I'm not sure what this is. But I have a large purple spot on each of my big toes. Not on the toenail but on the top of my toes. It looks just like one big nasty bruise. Its purple in color. It has been there since October of last year. I'm desperate and not sure what is causing this. I dont have health insurance. I did go see a podiatrist which hurt my pocket book. He told me it was bruising and if it didnt clear up in 2 months to come back. Well why if it was a bruise would it be there after 7 months!! Please, if anyone knows what this could be, respond. I dont know what to do and I cant even wear sandals for fear that someone will see the spots. And I live in a warm area. I have enclosed a photo of what it looks like. They spots are fairly light in this picture. They are normally much more purple in color.

[oceanbreeze4987]

It's been 4 years since I posted this photo. I wish I could say that my toes have gotten better. But, they have gotten so much worse. They have been consistently swollen. Sometimes extremely swollen, red, painful and itchy. I saw a dermatologist a few years ago. She did a skin biopsy and had mentioned lupus. Sent me for the blood tests. I had tested positive for the ANA. She did not diagnose me. I'm always dealing with the flare ups on my toes. They are rarely normally. Maybe had 3 weeks this whole year that they were normal, but still slightly swollen. The pain and swelling, and itching keep me up at night. My grandfather had lupus. I've done so much reading and show many signs of having this disease. Should I be concerned?  These flare ups are down right awful.

[Bhupinder Kaur, MD]

Hello,
Thanks for the clarification. If it is your toes and not the toe nails then peripheral vascular disease and Raynaud’s phenomenon need to be ruled out. Raynaud’s disease is a vascular disorder that affects blood flow to the extremities which include the fingers, toes, nose and ears when exposed to temperature changes or stress. This causes blueness and swelling of the skin.

I feel that a consultation of a physician will be the best. Other causes like peripheral vascular disease also has to be ruled out. It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.

[oceanbreeze4987]

It's not my nails that have the discoloration. Its my actual toe. the top of my toe. not the toenail. It's on my skin like a big old bruise. It shows not a single sign of going away.  Could this be the same thing as you describe earlier or something different

[Bhupinder Kaur, MD]

Hello,
Two possibilities are there for such purple discoloration of the nails. It can be due to hematoma formation or pseudomonas infection of the nails. In a hematoma, the blood is trapped between the nail bed and the nail plate. I suggest you to get it evaluated from a dermatologist and get the diagnosis confirmed as treatment is diagnosis specific.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.