Blackened Fingers—How Do They Happen?

It could be from inflammation or another health condition altogether.

This article was medically reviewed by Marissa Sansone, MD, who is board-certified in Internal Medicine, on June 16, 2022.

Photographs of medical conditions aren't usually pretty, but they can be fascinating—and they almost always teach us something about our bodies and our health. Take, for example, photos from a December 2018 issue of the New England Journal of Medicine that demonstrate what can happen when chronic inflammation goes unchecked throughout the body. Here's a hint and a warning: It involves blackened fingers and toes.

According to the authors of the report, an 84-year-old man went to his primary care doctor in Japan with discoloration and pain in his fingers and toes that had gotten worse over a two-week period. He'd also developed a 100-degree fever and general feelings of malaise, or weakness.

polyarteritis nodosa nejm vasculitis
New England Journal of Medicine

The patient presented with necrosis, or the death of body tissue, in his fingers and toes. He was tested for a variety of conditions, including infection, arterial embolism, and blood clotting disorders, all of which came back negative. Lab tests also revealed normal kidney and liver function, but they did show that he had an elevated C-reactive protein level, which is an indication of inflammation throughout the body.

The providers eventually diagnosed the patient with polyarteritis nodosa (PAN), a rare form of vasculitis that affects medium-sized blood vessels, according to the Genetic and Rare Diseases Information Center (GARD). Vasculitis is a condition in which a person's immune system attacks their blood vessels, causing inflammation that gradually thickens and weakens artery walls. This can result in restriction of blood to extremities like hands and feet—which occurred to the point of blackened fingertips and toes for the 84-year-old patient.

What else besides inflammation can lead to blackened fingers?

Varying shades of finger discoloration may be due to issues such as chilblains (small skin swellings), scleroderm (scar-like tissue buildup), frostbite, and peripheral artery disease (PAD), according to MedlinePlus. Sometimes, cold weather, smoking, or wearing uncomfortable shoes can change the color of fingers and toes. But blackened fingers, specifically, are caused by necrosis, general vasculitis, PAN, and two other conditions: Buerger's disease and Raynaud's disease.

Buerger's disease most often affects the blood vessels in the arms and legs, making them swell and restricting blood flow, which can cause clots, according to the John Hopkins Vasculitis Center. Symptoms include pain, tissue damage, and gangrene, the death or decay of tissue. Smokers are prone to the disease.

A rare blood vessel disorder, Raynaud's disease causes smaller vessels that supply the skin with blood to narrow so much that affected areas can turn white, blue, or red, according to MedlinePlus. Extremities may blacken due to decreased blood flow. Raynaud's disease mostly affects people who live in colder climates, have a family history of the disease and are older than 30, according to the Centers for Disease Control and Prevention (CDC).

What to do if your fingers turn black

You'll want to talk to your health care provider immediately if you see that your fingers are changing colors, especially in cases where the cause for the discoloration is unknown.

Your provider will do a physical exam and gather your medical history and symptom information. You may undergo certain tests, such as X-rays of your hands and feet, a comprehensive metabolic panel, or a urinalysis. This will help them determine how to move forward with your treatment plan.

Ultimately, when it comes to your health, don't hesitate to get medical attention for anything abnormal with your body—even if it's just your fingers or toes.

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