Peripheral cyanosis may be due to the following causes:
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
Differential cyanosis is the bluish coloration of the lower but not the upper extremity and the head. This is seen in patients with a patent ductus arteriosus. Patients with a large ductus develop progressive pulmonary vascular disease, and pressure overload of the right ventricle occurs. As soon as pulmonary pressure exceeds aortic pressure, shunt reversal (right-to-left shunt) occurs. The upper extremity remains pink because deoxygenated blood flows through the patent duct and directly into the descending aorta while sparing the brachiocephalic trunk, left common carotid, and left subclavian arteries. Evaluation
A detailed history and physical examination (particularly focusing on the cardiopulmonary system) can guide further management and help determine the choice of testing to be performed. Tests that can be performed include pulse oximetry, arterial blood gas, complete blood count, methemoglobin level,  electrocardiogram, echocardiogram, X-Ray, CT scan, cardiac catheterization, and hemoglobin electrophoresis. In newborns, peripheral cyanosis typically presents in the distal extremities, circumoral, and periorbital areas. Of note, mucous membranes remain pink in peripheral cyanosis as compared to central cyanosis where the mucous membranes are cyanotic. It is important to note that skin pigmentation and hemoglobin concentration can affect the evaluation of cyanosis. Cyanosis may be more difficult to detect on people with darker skin pigmentation.
The most common side effects with vonicog alfa (which may affect up to 1 in 10 patients) are dizziness, vertigo (a spinning sensation), dysgeusia (taste disturbances), tremor, rapid heartbeat, deep venous thrombosis (blood clot in a deep vein, usually in the leg), hypertension (high blood pressure), hot flush, vomiting, nausea (feeling sick), pruritus (itching), chest discomfort, sensations like numbness, tingling, pins and needles at the site of infusion, and an abnormal reading on the electrocardiogram (ECG). References
Further reading
AusPAR: Vonicog alfa. Therapeutic Goods Administration (TGA) (Report). October 2020. External links
"Vonicog alfa". Drug Information Portal. U.S. National Library of Medicine.