1Department of Dermatovenereology, Chengdu Second People’s Hospital, Chengdu, Sichuan, China
2Sexually Transmitted Disease Institute, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China
- Correspondence to: L Zhang zhleven{at}126.com
A woman in her late 30s presented with a three day history of bruising on both hands. The lesions began as pruritic erythema, rapidly progressing to purpura and swelling with mild pain. She had experienced several similar episodes over the past 20 years, occurring up to four times each year and resolving spontaneously within two weeks. No seasonal or temperature patterns were noted, she did not take any medication on a regular basis, and she had no history of trauma. A full blood count, coagulation profile, autoantibody screen, and previous Doppler ultrasonography results were normal.
Achenbach’s syndrome, or paroxysmal finger haematomas, was diagnosed. This benign, self-limiting disorder is characterised by sudden and recurrent spontaneous subcutaneous bleeding, pain, and swelling of the hands. Differential diagnoses include Raynaud’s phenomenon, acute limb ischaemia, microembolisms, chilblains, and acrocyanosis.1 Although the diagnosis relies on the presentation and clinical history, patients will often undergo extensive investigations to exclude clotting disorders and ischaemic events. The condition is not associated with serious underlying disease,2 so patients can be reassured and offered pain relief to manage the symptoms.13