Blue hue – what to do?
A case of chronic upper limb discolouration and paraesthesia poses a quandary, when an essential medicine is suspected as the cause.
Jean, an 86-year-old female, is a new admission to a nursing home. She reports she has had a few years of chronic bilateral upper limb discolouration.
On the left upper limb this is associated with tingling pain on light touch.
The symptoms have worsened in the last few months since an episode of rapid AF associated with heart failure, which required hospital admission for amiodarone loading.
Her past medical history includes AF with left ventricular dysfunction, gastro-oesophageal reflux disease, osteoarthritis, constipation and diverticulitis.
