A 68-year-old male chronic smoker with a history of long standing hypertension presented with a 3-month history of intermittent lower limb claudication, associated with bluish-purple discolouration of bilateral toes. He had no history of angiographic or vascular procedures, neither was he on anticoagulation treatment. On examination, his blood pressure reading was 125/65 mmHg. Bilateral blue toes were noted (Fig.1) with well palpable dorsalis pedis. The remainder of the physical examination was unremarkable.
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