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[5] Peripheral cyanosis may be due to the following causes: [5] All common causes of central cyanosis Reduced cardiac output (e.g., heart failure or hypovolemia) Cold exposure Chronic obstructive pulmonary disease (COPD) Arterial obstruction (e.g., peripheral vascular disease, Raynaud phenomenon) Venous obstruction (e.g., deep vein thrombosis) Differential cyanosis [edit] Differential cyanosis is the bluish coloration of the lower but not the upper extremity and the head