• Mickaël Chouk, Claire Vidon, Elise Deveza, Frank Verhoeven, Fabien Pelletier, Clément Prati, and Daniel Wendling.
• Department of Rheumatology, CHRU Besançon, boulevard Fleming, 25030 Besançon, France.
• Joint Bone Spine. 2017 Jan 1; 84 (1): 83-85.

AbstractIntravenous 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.Copyright © 2016 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

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