"Puffy hand syndrome"

Joint Bone Spine. 2017 Jan;84(1):83-85. doi: 10.1016/j.jbspin.2016.05.001. Epub 2016 Jun 3.

Abstract

Intravenous drug addiction is responsible for many complications, especially cutaneous and infectious. There is a syndrome, rarely observed in rheumatology, resulting in "puffy hands": the puffy hand syndrome. We report two cases of this condition from our rheumatologic consultation. Our two patients had intravenous drug addiction. They presented with an edema of the hands, bilateral, painless, no pitting, occurring in one of our patient during heroin intoxication, and in the other 2 years after stopping injections. In our two patients, additional investigations (biological, radiological, ultrasound) were unremarkable, which helped us, in the context, to put the diagnosis of puffy hand syndrome. The pathophysiology, still unclear, is based in part on a lymphatic toxicity of drugs and their excipients. There is no etiological treatment but elastic compression by night has improved edema of the hands in one of our patients.

Keywords: Edema; Hand; Puffy hand; Toxicomania.

MeSH terms

  • Adult
  • Female
  • Hand / physiopathology*
  • Heroin Dependence / complications*
  • Humans
  • Lymphatic System / drug effects
  • Lymphatic System / physiopathology
  • Lymphedema / etiology*
  • Lymphedema / physiopathology
  • Male
  • Physical Examination
  • Rare Diseases
  • Sampling Studies
  • Severity of Illness Index
  • Syndrome