paroxysmal bruising in the finger -achenbach’s syndrome

Images Paroxysmal Bruising in the Finger -Achenbach’s Syndrome- Shin Watanabe 1) , Naoyuki Hashiguchi 1) , and Hiroyuki Kobayashi 2) 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 inflamma- tion, 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 wom- en. The index and middle fingers are the most affected, and AS may be palmar (2) . This disease does not spread to the fin- gertips, and AS is distinguishable from ischemic lesions. Spe- cific treatment is not required, and the patient may recover spontaneously within 1 week with local rest. A general practi- tioner familiar with the disease can reassure the patient (3) . Informed written consent was obtained from the patient. Article Information Conflicts of Interest None IRB Approval Code JHS 18-018 Juntendo University Hospital Independent Eth- ics Committee. References 1. Achenbach W. The paroxysmale hand-hematoma. Medizinische. 1958;52(27):2138-40. 2. Eikenboom JC, Cannegeiter SC, Breit E. Paroxysmal finger haematoma: a neglected syndrome. Thromb Haemost. 1991;66(2):266. 3. Yamamoto Y, Yamamoto S. Achenbach’s syndrome. N Engl J Med. 2017;376:e53. JMA Journal is an Open Access journal distributed under the Crea- tive Commons Attribution 4.0 International License. To view the de- tails of this license, please visit (http://creativecommons.org/ licenses/by/4.0/). 1) Department of Emergency and Disaster Medicine, Juntendo University, Tokyo, Japan.. 2) Department of General Medicine, Juntendo University, Tokyo, Japan. Corresponding author: Shin Watanabe, [email protected] JMA J. 2019;2(1):89-90 Received: September 13, 2018 / Accepted: September 28, 2018 / Advance Publication: November 12, 2018 / Published: March 4, 2019 Copyright © Japan Medical Association DOI: 10.31662/jmaj.2018-0033 https://www.jmaj.jp/ 89

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Paroxysmal Bruising in the Finger -Achenbach’s Syndrome-

Shin Watanabe1), Naoyuki Hashiguchi1), and Hiroyuki Kobayashi2)

Key Words:Achenbach’s syndrome, Bruising, Finger

A 70-year-old man, who was not on anticoagulants, presentedwith sudden onset of spontaneous painless bruising of his leftmiddle finger without prior trauma (Figure 1). After rulingout thrombocyte abnormalities, coagulopathy, and inflamma-tion, 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 hemato-ma at the same site. AS is more common in middle-aged wom-en. The index and middle fingers are the most affected, andAS may be palmar (2). This disease does not spread to the fin-gertips, and AS is distinguishable from ischemic lesions. Spe-cific treatment is not required, and the patient may recoverspontaneously within 1 week with local rest. A general practi-tioner familiar with the disease can reassure the patient (3).

Informed written consent was obtained from the patient.

Article Information

Conflicts of InterestNone

IRB Approval CodeJHS 18-018 Juntendo University Hospital Independent Eth-ics Committee.

References1. Achenbach W. The paroxysmale hand-hematoma.

Medizinische. 1958;52(27):2138-40.2. Eikenboom JC, Cannegeiter SC, Breit E. Paroxysmal finger

haematoma: a neglected syndrome. Thromb Haemost.1991;66(2):266.

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

JMA Journal is an Open Access journal distributed under the Crea-tive Commons Attribution 4.0 International License. To view the de-tails of this license, please visit (http://creativecommons.org/licenses/by/4.0/).

1) Department of Emergency and Disaster Medicine, Juntendo University, Tokyo, Japan.. 2) Department of General Medicine, Juntendo University, Tokyo,Japan.Corresponding author: Shin Watanabe, [email protected] J. 2019;2(1):89-90Received: September 13, 2018 / Accepted: September 28, 2018 / Advance Publication: November 12, 2018 / Published: March 4, 2019Copyright © Japan Medical Association

DOI: 10.31662/jmaj.2018-0033https://www.jmaj.jp/