Achenbach's Syndrome in a 30-year-old Healthy Woman

A previously healthy 30-year-old Japanese woman presented with a sudden onset of a fever with pain and swelling of her left third finger. She denied using any medications, any recent trauma, or a history of similar episodes. A physical examination showed a subcutaneous hematoma and swelling of the third finger (Picture). Laboratory tests revealed no platelet deficiency or coagulation disorders, and all results were within normal ranges. Her symptoms improved within three days without treatment or relapse. Therefore, she was clinically diagnosed with Achenbach's syndrome. Achenbach's syndrome usually presents with sudden onset of subcutaneous bleeding in the fingers, particularly in women. Middle-aged women often developed this syndrome; however, a few reports have shown that even patients under 30 years of age can develop it (1,2). Although this syndrome might be induced by external force, patients without any identifiable cause often develop this syndrome (2). This syndrome is characterized by exacerbation and remission without treatment and is diagnosed by the exclusion of diseases, such as trauma, vasculitis, and atherosclerosis (1,2). It may therefore be difficult to accurately diagnose this condition. Although the symptoms often disappear within several days, a few cases have demonstrated relapse (1,2). The present case emphasizes the importance of considering Achenbach's syndrome in the differential diagnosis of women presenting with swollen fingers in the absence of any other risks for bleeding.

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The author states that he has no Conflict of Interest (COI).