Palmar Digital Vein Thrombosis: A Case Report and Review of 36 Cases

Abstract

Thrombosis of the palmar digital veins is relatively rare, typically reported in women aged 35-65 years and most commonly occurring on the fourth digit. Clinical presentation varies and the lesion can present on the fingers or the palms of the hands. Diagnosis may be suspected clinically and confirmed on histology and radiologically. The condition can be managed conservatively or surgically. A 58-year-old woman presented with a 3-month history of a tender, skin-coloured nodule on her right palm. This was surgically excised, and the histopathological diagnosis was a thrombosed varix. As no underlying medical issues were raised on further testing, it was thought that her thrombosed varix was likely secondary to repeated trivial mechanical trauma, given that she was a housewife. A literature review yielded 36 cases of thrombosed varix, including our case. Most cases (85.3%) occurred in females, and the mean age of patients was 51.67 years, with two-thirds of patients between 35 and 65 years of age. The fourth digit and the proximal interphalangeal joint were the most commonly affected sites, respectively. Although rare, doctors should consider the possibility of a thrombosed varix when presented with tender and raised nodules on the palms or fingers.

Palmar Digital Vein Thrombosis in a Patient with Carpal Tunnel Syndrome: A Coincidence or an Association?

“…Since its first description by Jadassohn in 1936, only 37 cases have been reported in the literature. [ 1 2 ] It presents as spontaneous painful nodules on the palmar aspect of the digits, found at or near the level of the proximal interphalangeal joints, but can also be located over the middle or distal interphalangeal joints. [ 2 ] The exact etiopathogenesis of palmar digital vein thrombosis is unclear.…”

“…[ 1 2 ] It presents as spontaneous painful nodules on the palmar aspect of the digits, found at or near the level of the proximal interphalangeal joints, but can also be located over the middle or distal interphalangeal joints. [ 2 ] The exact etiopathogenesis of palmar digital vein thrombosis is unclear. According to “Virchow's triad,” endothelial injury, hypercoagulability, and stasis are the mechanisms predisposing to the formation of venous thrombosis.…”

“…Though there are a few reports of its association with conditions having hypercoagulability such as antiphospholipid antibodies, concomitant deep vein thrombosis, oral contraceptive pills, and coronavirus disease 2019 (COVID-19) infection, the majority of cases have occurred spontaneously with no underlying coagulation disorder. [ 2 ] In addition, previous reports point to female predisposition with 85% of reports in females. [ 1 2 ] This is a report of recurrent palmar digital vein thrombosis in a patient with carpal tunnel syndrome, along with a discussion on its possible association.…”

“…[ 2 ] In addition, previous reports point to female predisposition with 85% of reports in females. [ 1 2 ] This is a report of recurrent palmar digital vein thrombosis in a patient with carpal tunnel syndrome, along with a discussion on its possible association.…”