Achenbach's syndrome

A 60-year-old woman, with unremarkable medical history, presented in our emergency department with sudden appearance of painful bruise of her right-hand middle-finger. She denied previous similar episodes, preceding stress or trauma situation, cold exposure, or medication.

Middle-finger was swollen, with bruises on both surfaces (yellow-arrows) (fig. 1), was warm and well-perfused, with normal radial-pulse.

Fig. 1

Laboratory-tests, radiography and Doppler-ultrasonography were normal. It resolved within 4-days, with no treatment.

Based on clinical presentation, normal exams, and benign course we diagnosed Achenbach’s syndrome, also called paroxysmal finger hematoma or acute idiopathic blue finger.

Of unknown etiology, supposedly is a vascular disorder; triggered by increased local micro-vascular fragility, related to advanced age or minor trauma, originating bruising, mainly with acute pain or burning sensation, sometimes movement limitation and can affects one or more fingers of hands or feet.

With low prevalence, recently noticed familial tendency, observed mostly in middle-aged women, with spontaneously improvement after a few days, without sequelae, but recurrent episodes are usual.

Achenbach’s syndrome is mainly an exclusion diagnosis, so efforts should be done to rule out other conditions as trauma, Raynaud-phenomenon, acute ischemia, Buerger’s disease, acrocyanosis, vasculitis, Psychogenic-purpura. Associations with diseases such as gastrointestinal disorders, migraine, goiter, and neoplasms have also been noted.

Conflicts of Interest

The authors declare that there is no conflict of interest in this work.

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