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May 3, 1965

Unilateral Clubbing and Cyanosis of Toes

JAMA. 1965;192(5):423-424. doi:10.1001/jama.1965.03080180081035

To the Editor:—  Clubbing of the digits has intrigued observers throughout medical history. Just-Viera1 has recently summarized the current theories of etiology and associated findings. Unilateral clubbing is particularly unusual and prompts the recording of the following patient.A 6-year-old white female was referred for evaluation of cyanosis and clubbing of the toes of her left foot. She was the product of a pregnancy terminated prematurely by cesarean section for placenta praevia. At birth she was noted to have clubbing and cyanosis of all toes of the left foot. There were large tortuous veins on the dorsal and lateral surfaces of the foot, and a small subcutaneous nodule on the dorsum of the left third toe. Growth and development were normal. The only change in the foot was disappearance of the cyanosis of the great toe. There were no symptoms referable to the abnormality, and no family history of