Achenbach syndrome is a rare, benign condition that involves swollen and bruised-looking (or “blue”) fingers and toes. It is not connected to other health conditions but may mimic their symptoms.

Achenbach syndrome is a rare condition that causes sudden swelling, discoloration, and sometimes pain in your fingers and toes. It was named after the German doctor Walter Achenbach, who first described it in the 1950s.

It also goes by several other names such as:

  • acute idiopathic blue finger syndrome
  • paroxysmal finger hematoma
  • paroxysmal hand hematoma
  • finger apoplexy

Achenbach syndrome most commonly affects middle-aged females. It has no known cause and doesn’t usually cause complications.

Fewer than 100 cases of Achenbach syndrome have been reported in the medical literature.

Read on to learn more about this rare condition, including its symptoms, why it may develop, and treatment options.

Achenbach syndrome causes sudden swelling, tingling, pain, and bruising in your fingers or toes. These symptoms usually happen quickly, without an obvious trigger like physical trauma or exposure to cold temperatures.

They almost always go away without treatment in 2–14 days, according to a 2023 case report.

Some people may develop recurrent flare-ups of symptoms. These flare-ups might occur months or years apart, the 2023 report notes.

Examples of Achenbach Syndrome

A 2022 case series included four females with Achenbach syndrome. Here’s a look at their symptoms:

  • A 66-year-old experienced bluish-purple discoloration on some of her fingers that happened 2–3 times per year. She had some tingling without pain. Each episode lasted a few days. On a physical exam, doctors noticed her fingers were warm.
  • A 54-year-old had reoccurring cases of mildly painful swelling with blue discoloration of her knuckles. She reported that her teenage daughter had similar symptoms. Her symptoms went away within a few days without treatment.
  • A 64-year-old had recurrent episodes of sudden painless black-and-blue discoloration in her feet and toes that was preceded by a tingling sensation. Most of the coloring disappeared in 3 days, but some turned black and disappeared within about a week.
  • A 45-year-old had sudden finger swelling and tingling in her middle finger on one hand. She gradually developed blue discoloration and her symptoms resolved within a few days.
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Achenbach syndrome symptoms compared with other conditions

Due to its rarity, most cases of Achenbach syndrome are thought to be misdiagnosed. It may be misdiagnosed as primary Raynaud phenomenon. Primary Raynaud phenomenon is decreased blood flow caused by blood vessel spasms. It affects your fingers or other areas such as your:

  • ears
  • toes
  • nipples
  • nose

Achenbach syndrome may also be misdiagnosed as embolic digital artery occlusion or dermatitis artefacta.

Embolic digital artery occlusion is when a blood clot or other substance in your blood blocks an artery in your finger or toe. Dermatitis artefacta is a mental health condition where somebody damages their skin or other areas, usually for attention or to avoid responsibility.

Here’s a look at how the symptoms and triggers of these four conditions compare:

Achenbach syndromePrimary Raynaud phenomenonDigital artery occlusionDermatitis artefacta
Triggersno obvious trigger• cold
• emotional distress
blood clotpsychological factors
Body partsfingers or toes• fingers
• toes
• nipples
• nose
• knees
fingers or toes• skin
• hair
• nails
• face
• hands and forearms
• legs and feet
Symptoms• tingling
• swelling
• pale white or blue skin
• swollen and painful hands when warmed
• sores on fingers
• pale or blue skin
• numbness or tingling
• cold feeling in affected finger or toe
• ulcers or gangrene
• unusual burns
• bruises
• bleeding

The cause of Achenbach syndrome isn’t known, and it hasn’t been linked to any other health conditions. Achenbach syndrome has been reported in multiple generations of the same family, which means it might at least partially develop due to genetic factors.

Researchers have proposed that it might be caused by fragile blood vessels in your fingers or toes. A small, unnoticed trauma may damage these blood vessels and cause bruising and swelling.

Achenbach syndrome is most common in middle-aged females. It’s very rare in people under age 40 years but has been reported, such as in the case of a 26-year-old woman who developed symptoms while doing yoga.

In a 2019 analysis of 24 people with Achenbach’s syndrome, 83.33% were female.

Most reported cases have occurred in Caucasian women, but this might be because discoloration is easier to notice on lighter skin.

Achenbach syndrome seems to be a self-resolving condition. This means that symptoms go away by themselves without any particular treatment.

If you have pain, you can try taking over-the-counter pain relievers such as ibuprofen.

People who receive a diagnosis of Achenbach syndrome may have anxiety that their symptoms are caused by a serious medical condition. However, Achenbach syndrome isn’t associated with any serious complications.

Because some conditions that cause similar symptoms, such as digital artery occlusion, can cause serious complications, it’s a good idea to visit your doctor if your bruising and swelling don’t start to improve within a few days or if you have severe pain.

Achenbach syndrome involves sudden swelling, tingling, and discoloration in your fingers or toes. It has no known cause, is not associated with other health conditions, and usually resolves within days.

Treatment isn’t needed for Achenbach syndrome, but it can mimic some conditions that do require treatment. It’s a good idea to visit your doctor if your symptoms aren’t improving or get worse within a few days.