Puffy hand syndrome

Doctors in Italy have reported an unusual case of peripheral oedema that turned out to go hand in hand with the patient’s IV drug use.

The 45-year-old man presented to a rheumatology outpatient unit with severe bilateral swelling of his hands, extending to his forearms, which had slowly developed over the past three years.

The localised oedema was non-pitting and unaffected by elevation. Symmetrical cyanosis of the dorsa of his hands was also evident. Surprisingly, the swelling did not reduce hand function.

Blood tests detected hepatitis C and an