• L Chantalat, M Simon, C Fourgeaud, and S Vignes.
• Unité de Lymphologie, Site constitutif du Centre national de référence des maladies vasculaires rares (lymphœdèmes primaires), Hôpital Cognacq-Jay, 15 rue Eugène Millon, 75015 Paris, France.
• Rev Med Interne. 2020 Oct 1; 41 (10): 700-703.

IntroductionPuffy hand syndrome is a rare complication of intravenous drug addiction. Diagnosis is based on the patient's history and clinical examination.ObservationsA woman and two men, aged 42, 39 and 36 years old, are described. All had a history of intravenous drug use of heroin and oral buprenorphine misuse. Puffy hand syndrome appeared during drug addiction (n = 2) or after its withdrawal (n = 1). It was associated with acrocyanosis (n = 1) or injection scars (n = 1). Upper limb ultrasonography showed sequelae of venous (n = 3) or arterial (n = 1) thrombosis. An upper limb lymphoscintigraphy in one patient showed decreased radionuclide uptake of axillary lymph node and subdermal reflux tracer in the forearm. Treatment was based on low-stretch bandages to reduce the volume and then elastic compression sleeve for long-term stabilization.ConclusionPuffy hand syndrome seen in intravenous drug addicts is poorly understood. It is a chronic complication despite the cessation of drug use. This syndrome has to become more widely known because its management is mandatory, although symptomatic.Copyright © 2020. Published by Elsevier Masson SAS.

29 keywords...

hide…