Paroxysmal finger haematoma: A case of Achenbach's syndrome

A 38-year-old woman presented with sudden bruising and pain in her finger, 60 minutes after a burning sensation and discomfort. She had had similar episode 6 months earlier in the middle finger, which had resolved spontaneously in 5 days. She didn’t identified any particular triggers, no history of trauma or consume of anticoagulants. She had a medical history of migraine and she was a non smoker. On examination, the 4^th right finger had a ecchymotic discoloration and swelling about the volar aspect (Fig. 1), with moderate pain to palpation, without sensibility or mobility alteration and with normal capillary refill. Laboratory tests did not show thrombocyte abnormalities or coagulopathy. Doppler ultrasonography showed normal flow. An Achenbach's syndrome, a rare clinical condition which causes paroxysmal spontaneous subcutaneous bleeding in the fingers, was diagnosed. The cause remains unknown and recurrence rate is variable. It doesn’t require an admission or investigations, since the diagnosis is made on the basis of clinical presentation. Laboratory tests and Doppler are normal, but they are helpful in the differential diagnosis. This syndrome is self-limiting and resolved in one week without treatment.

Fig. 1