Achenbach syndrome

Achenbach syndrome is a self-limiting, recurrent, painful bruising of the finger(s) or palm, and occasionally the toe(s), that is not associated with serious underlying conditions.

• Achenbach syndrome is a subcutaneous bruise probably due to minor fragility of capillaries or a small vein in the palmar skin. Preceding minor trauma may be recalled in 30% of cases 

• It is more common in females

• Medications, bleeding disorders, and rheumatological conditions are not related 

• The swelling is often described as painful

• Acute onset of pain followed minutes to hours later by swelling and blue-purple discolouration 

• The palmar aspect of the dominant hand is the most common site with the index and middle fingers being the most commonly affected, although any finger or toe can be involved. Sparing of the nail bed is characteristic

• Complete resolution of the symptoms usually occurs within a few days, although symptoms occasionally last longer. The colour changes do not follow the same pattern one would expect to see in a bruise 

• There is no effective treatment