"Puffy hand syndrome".
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.
Department of Rheumatology, CHRU Besançon, boulevard Fleming, 25030 Besançon, France.
Mickaël
M
Chouk
Department of Rheumatology, CHRU Besançon, boulevard Fleming, 25030 Besançon, France.
Claire
C
Vidon
Department of Dermatology, CHRU Besançon, boulevard Fleming, 25030 Besançon, France.
Elise
E
Deveza
Department of Rheumatology, CHRU Besançon, boulevard Fleming, 25030 Besançon, France.
Frank
F
Verhoeven
Department of Dermatology, CHRU Besançon, boulevard Fleming, 25030 Besançon, France.
Fabien
F
Pelletier
Department of Rheumatology, CHRU Besançon, boulevard Fleming, 25030 Besançon, France.
Clément
C
Prati
Department of Rheumatology, CHRU Besançon, boulevard Fleming, 25030 Besançon, France. Electronic address: dwendling@chu-besancon.fr.
Daniel
D
Wendling
D000328:Adult; D005260:Female; D006225:Hand / Q000503:physiopathology*; D006556:Heroin Dependence / Q000150:complications*; D006801:Humans; D008208:Lymphatic System / Q000187:drug effects / Q000503:physiopathology; D008209:Lymphedema / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D010808:Physical Examination; D035583:Rare Diseases; D012494:Sampling Studies; D012720:Severity of Illness Index; D013577:Syndrome
Edema; Hand; Puffy hand; Toxicomania