The Puffy Hand Syndrome is an uncommon complication of intravenous drug addiction.
Clinical features:
(1) history of intravenous drug abuse, often heroin
(2) edema of one or both hands
(3) variable acrocyanosis
(4) variable injection scars
(5) variable episodes of cellulitis
(6) decreased range of motion in fingers and wrists, which may be disabling
The edema is initially pitting but eventually becomes non-pitting in long-standing cases.
Imaging studies:
(1) multiple arterial and/or venous thrombi in the ipsilateral upper extremity
(2) abnormal lymphatic drainage on lymphoscintigraphy
A pitting foot syndrome can develop in patients who inject drugs into their lower extremities.
