Q: What is Purple toe syndrome?

Answer:  It is a rare complication that may occur usually within first 2 months  of commencement of warfarin treatment. Recently, it has been reported after 1 year of warfarin therapy1.

With anti coagulation, minor deposits of cholesterol break loose and flow into the feet, which causes a blueish purple and painful toe. It  typically affect the big toe, but it can affects other parts of the feet as well.

Treatment is discontinuation of warfarin.

Further read: Talmadge DB, Spyropoulos AC (2003). "Purple toes syndrome associated with warfarin therapy in a patient with antiphospholipid syndrome". Pharmacotherapy 23 (5): 674–7. Link: http://www.ncbi.nlm.nih.gov/pubmed/12741443

1. Late Onset Purple Toe Syndrome With Warfarin Successfully Treated With Fondaparinux - American Journal of Therapeutics:, November 2011 - Volume 18 - Issue 6 - pp e277-e279