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©2013 UpToDate ® Print Email Blue toe syndrome Blue toes are a classic manifestation of peripheral embolization of atheromatous material from proximal arterial sources (eg, aorta); the pedal pulses are often normal. This patient, who has a 30-year history of type 1 diabetes and severe peripheral vascular disease, presented with foot pain and discoloration. Cholesterol microemboli from the aorta were suspected to be the cause. Reproduced with permission from Lawrence B Stack, MD. Copyright © Lawrence B Stack, MD.