A previously healthy 66-year-old woman presented with sudden-onset pain and bruising in her right middle finger. She had had a similar episode 3 weeks earlier, which had resolved spontaneously within a few days. She did not take any regular medication and reported that she had not had any recent trauma.
A physical examination revealed subcutaneous hematoma and swelling with normal capillary refill and sensation. The skin color of the fingers did not change in response to exposure to cold.
Laboratory tests revealed a normal platelet count and no coagulopathy. A clinical diagnosis of Achenbach’s syndrome was made.
Achenbach’s syndrome is characterized by paroxysmal spontaneous subcutaneous bleeding in the fingers and hands. Although the cause is unknown, it is a self-limiting condition. Patients may seek medical care out of fear because of the sudden pain and bleeding; therefore, diagnosing this condition may relieve anxiety. The patient’s signs and symptoms resolved spontaneously within 1 week without treatment.