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Paroxysmal Bruising in the Finger -Achenbach’s Syndrome-

Shin Watanabe1, Naoyuki Hashiguchi1, and Hiroyuki Kobayashi2
1Department of Emergency and Disaster Medicine, Juntendo University, Tokyo, Japan.
2Department of General Medicine, Juntendo University, Tokyo, Japan.

Corresponding author: Shin Watanabe, snwatana@juntendo.ac.jp

DOI: 10.31662/jmaj.2018-0033

Received: September 13, 2018
Accepted: September 28, 2018
Advance Publication: November 12, 2018

Key words: Achenbach’s syndrome, Bruising, Finger

A 70-year-old man, who was not on anticoagulants, presented with sudden onset of spontaneous painless bruising of his left middle finger without prior trauma (Figure 1). After ruling out thrombocyte abnormalities, coagulopathy, and inflammation, we diagnosed Achenbach’s syndrome (AS). In 1958, Achenbach first described “paroxysmal hand hematoma” or “finger apoplexia” (1).

The cause of this disease is not known till date; however, pain and numbness develop suddenly followed by a hematoma at the same site. AS is more common in middle-aged women. The index and middle fingers are the most affected, and AS may be palmar (2). This disease does not spread to the fingertips, and AS is distinguishable from ischemic lesions. Specific treatment is not required, and the patient may recover spontaneously within 1 week with local rest. A general practitioner familiar with the disease can reassure the patient (3).

Informed written consent was obtained from the patient.

Figure 1. Bruising of the left middle finger.

Article Information

Conflicts of Interest

None

IRB Approval Code

JHS 18-018 Juntendo University Hospital Independent Ethics Committee.

References

  1. 1.

    Achenbach W. The paroxysmale hand-hematoma. Medizinische. 1958;52(27):2138-40.

  2. 2.

    Eikenboom JC, Cannegeiter SC, Breit E. Paroxysmal finger haematoma: a neglected syndrome. Thromb Haemost. 1991;66(2):266.

  3. 3.

    Yamamoto Y, Yamamoto S. Achenbach’s syndrome. N Engl J Med. 2017;376:e53.

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