INTRODUCTION

Achenbach’s syndrome is a rare, benign vascular condition characterized by spontaneous bruising of the digits [1]. First described by Walter Achenbach in 1958, this condition predominantly affects middle-aged women [2,3]. The recognition of this syndrome is crucial to prevent unnecessary diagnostic procedures and the patient’s anxiety [4].

CASE REPORT

A 55-year-old woman presented with a ten-year history of recurrent painful discoloration of the fingers. Episodes occurred spontaneously or following physical activity, affecting primarily the left thumb (Fig. 1) [5]. Physical examination revealed subcutaneous hematoma with normal capillary refill. Laboratory investigations, including platelet count, coagulation profile, C-reactive protein, and autoantibody screening, were unremarkable [6]. The condition resolved spontaneously within 5–7 days without intervention.

Figure 1: Characteristics of Achenbach’s syndrome: subcutaneous hematoma affecting the patient’s left thumb.

DISCUSSION

This case illustrated the classic presentation of Achenbach’s syndrome [7]. The patient’s age, sex, and clinical presentation aligned with the typical features of this condition [1,3]. The spontaneous resolution without complications and normal laboratory findings supported the benign nature of this syndrome [4].

Achenbach’s syndrome is a benign, self-limiting condition with unknown etiology that predominantly affects middle-aged women, with a female-to-male ratio of approx. 8:1. The condition is characterized by spontaneous bleeding from fragile capillaries or small veins, with 70% of cases occurring spontaneously and 30% following minor trauma or hand activity. Despite its alarming appearance, it has no association with systemic vascular diseases or coagulopathies. The characteristic acute onset and self-limiting nature help to differentiate it from other causes of discoloration, and no specific treatment is required, making it important to avoid unnecessary interventions [2,3].

Its pathophysiology remains unclear, although some theories suggest microtrauma to digital vessels or the role of abnormal vascular fragility. The benign nature of this condition makes it crucial for healthcare providers to recognize its clinical presentation to prevent unnecessary diagnostic procedures and the patient’s anxiety. Understanding these characteristics helps to differentiate it from more serious vascular conditions requiring urgent intervention [5,6].

CONCLUSION

Achenbach’s syndrome remains a diagnosis of exclusion yet should be considered in cases of spontaneous digital bruising, particularly in middle-aged women [7]. This case emphasized the importance of recognizing this benign condition to avoid unnecessary investigations and interventions [1,4].