Achenbach syndrome: Sudden discoloration and pain in fingers

Achenbach syndrome is a condition in which a patient experiences sudden attacks of bruising, bleeding, swelling and pain in the hand or fingers for unknown reasons. The condition is often very alarming, but is benign in nature and the symptoms disappear after a short time. Supportive treatment is necessary to relieve the symptoms during an attack. Symptoms often return in patients with the rare disease, but the frequency varies. The condition was first described in the medical literature by Walter Achenbach in 1958.

  • Synonyms of Achenbach syndrome
  • Causes of problems with fingers and hands
  • Symptoms: Pain, bleeding, swelling and discoloration
  • Diagnosis and examinations
  • Treatment of rare disease
  • Prognosis of benign condition


Synonyms of Achenbach syndrome

Achenbach syndrome is also called paroxysmal hand hematoma or finger apoplexy by doctors.

Causes of problems with fingers and hands

Episodes of problems with the fingers or hands occur spontaneously or after minor trauma. The exact cause of this syndrome is still a mystery in October 2020. A subcutaneous (under the skin) bruising may play a role. Another scientific study reports that this condition may be the result of restricted blood flow to the fingers.

Symptoms: Pain, bleeding, swelling and discoloration

Frequent attacks of pain, color changes and bleeding usually occur on the middle and index fingers, but sometimes the little finger or another finger is also involved. The symptoms are also present on parts of the hand(s).A few hours before an attack, signs such as pain, tingling and itching occur. Subsequently, active bleeding and red or blue discoloration (bruising) occur on the fingers. The bleeding usually stops within minutes after application of local pressure. The discoloration also disappears after four to six days. During this period there is a loss of function of the fingers. The patient also experiences sudden, intense and burning pain (finger pain), inflammation and swelling of the fingers. Serious bleeding in other organs does not occur. The fingertip and nail bed are not involved in Achenbach syndrome, which differs from ischemic diseases. The patient often suffers from anxiety due to the disease due to the sudden finger problems.

Diagnosis and examinations

Physical and diagnostic examination

The diagnosis is strictly based on clinical features of Achenbach’s syndrome, as all standard examinations such as a Doppler ultrasound (imaging study of blood vessels) reveal normal results. An angiography (radiographic image of the blood vessels) is necessary to rule out another condition, but this imaging test is usually unnecessary because the doctor already suspects, based on the characteristic history and the presentation of the condition, that the patient is suffering from Achenbach syndrome.

Differential diagnosis

The doctor must be well aware of this disease because it is easy to confuse Achenbach syndrome with other serious conditions. This leads to unnecessary diagnostic tests and mental anguish for the patient. It is often a challenge for the doctor to distinguish this syndrome from other conditions in which a bluish discoloration of the fingers also occurs, such as occlusive arterial diseases, connective tissue diseases, the use of medicines (such as ergotamine), nerve damage and shoulder girdle syndrome (pressure on the nerve). and/or blood vessels). However, these conditions often involve all fingers at the same time and usually involve other systemic symptoms or other abnormalities of blood vessels, nerves or blood. Another condition reminiscent of Achenbach’s syndrome is painful contusion syndrome or autoerythrocyte sensitization syndrome. However, this also causes bruises on the legs and torso.

Treatment of rare disease

The patient needs good guidance to reduce anxiety during acute episodes and also to avoid any triggering factors. Furthermore, the patient treats this disease supportively, namely by applying alternating hot and cold compresses in combination with taking painkillers.

Prognosis of benign condition

The disease seems alarming to both the doctor and the patient, but the symptoms of an attack disappear after a short time, usually within a week. Occasionally the complaints last up to two weeks. Recurrent episodes may occur at variable time intervals.

read more

  • Blue or purple fingers: Causes of blue discoloration
  • Burning hands: Causes of burning sensation in hands
  • Pain in finger (finger pain): Causes of sore fingers

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