Abstract Body

Background and purpose

Paroxysmal hematoma of the fingers refers to a clinical picture where patients suffer sudden episodes of pain and edema of one or more fingers with subsequent appearance of predominantly hematomas in the palmar region of the proximal phalanges. It is a rare and benign process of unknown etiology. The first symptoms are severe pain, tingling and itching prior to the change in skin color. There is self-limited subdermal bleeding that disappears in the following days. The diagnosis is clinical with normal complementary tests. The main differential diagnosis is with acute ischemic processes because they have a similar presentation. Its evolution is benign and resolves without leaving sequel.

Methods and results

A 64-year-old female patient,without allergies, non-smoker, with a history of hypertension, dyslipidemia and anxiety. Current treatment, alprazolam 0.25mg/8 hours, bisoprolol 5mg/24 hours, hydrosalurethyl 50mg/24 hours, simvastatin 20mg/24 hours.

Consulting for sudden and very intense pain with subsequent appearance of hematoma in the palmar region of the fourth finger of the right hand. At the time of the examination, she had no pain with correct mobility,we observed hematoma at proximal phalanx and the middle of the fourth finger. Good distal capillary filling, radial and ulnar pulse present. Analytical non-coagulation alterations rule out autoimmune diseases. Arterial echo Doppler of the upper limb without alterations. Evolutionary control in 5 days shows process in resolution.

Conclusion

Although it´s a rare entity to see in the consultory,it´s necessary for the general practitioner to be aware of it in order to be able to advise the patient correctly and avoid unnecessary complementary studies.