Two Cases of Thrombosis of the Palmar Digital Vein

Kim, Heung Yeol; Cho, Eun Byul; Youn, Sang Ho; Park, Eun Ju; Kwon, In Ho; Kim, Kwang Ho; Kim, Kwang Joong

doi:10.5021/ad.2012.24.3.351

Cited by 8 publications

(4 citation statements)

References 8 publications

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“…Isolated thrombosis of a digital vessel is rare in occurrence. 4 These injuries are often secondary to trauma and commonly observed in crush injuries. This patient received an intralesional injection of Candida albicans antigen for treatment of a subungual wart and subsequently developed distal fingertip ischemia of her radial soft tissue.…”

Section: Discussionmentioning

confidence: 99%

“…While there is limited literature regarding the management of digital vein thrombosis, conservative management remains the preferred treatment algorithm in the setting of a well-perfused digit. 4 , 7 We elected to monitor the patient in an inpatient setting for tissue demarcation. In the interim, the patient was maintained on a heparin drip to ameliorate the risk for possible progression of proximal thrombus formation, as well as nitroglycerin paste to promote venous dilation.…”

Section: Discussionmentioning

confidence: 99%

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Fingertip ischemia following intralesional injection of <i>Candida albicans</i> antigen for treatment of a subungual wart

2023

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Subungual or periungual cutaneous warts are caused by the Human Papillomavirus (HPV). These lesions can be refractory to destructive therapy, necessitating the use of intralesional immunotherapies such as Candida albicans antigen. In this case report, we present a 23-year-old female who sustained distal fingertip soft tissue necrosis following intralesional injection of Candida albicans antigen for treatment of a refractory subungual wart. While this patient recovered appropriately with conservative bedside debridement and local wound care, intralesional injections to the digit, or hand are not without sequela. Care must be taken to inject intradermal and avoid the underlying digital vasculature. In this case, the radial digital vessels were traumatized upon injection, leading to digital ischemia and soft tissue necrosis. While isolated soft tissue ischemia without compromised perfusion can be treated conservatively, these injuries should be evaluated by a hand surgeon to determine the need for emergent revascularization, or future soft tissue reconstruction.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Fingertip ischemia following intralesional injection of <i>Candida albicans</i> antigen for treatment of a subungual wart

2023

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“…Inherited or acquired hypercoagulable states may also give rise to thrombosis of the palmar veins, with 8 out of 23 (34.8%) reported cases being secondary to hypercoagulable states. Documented causes included recurrent venous thromboembolism since adolescence of uncertain aetiology [ 2 ] , isolated high levels of IgM antiphospholipid antibodies [ 6 ] and factor V Leiden mutation [ 7 ] , recent surgery to the upper limb [ 1 ] and malignancy (prostate cancer) [ 8 ] . Drugs known to increase the risk of venous thromboembolic events, namely hormonal treatment including the combined oral contraceptive pill [ 9 ] and the intrauterine device containing levonorgestrel, have also been reported [ 6 ] .…”

Section: Discussionmentioning

confidence: 99%

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

Farrugia

Cachia

DeGaetano

et al. 2022

European Journal of Case Reports in Internal Medicine

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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.

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“…Venous thrombosis can be associated with drugs, connective tissue disease and hypercoagulability disorders such as advanced malignancy. Palmar digital vein thrombosis has scarcely been described . Differential diagnoses include vein varicosities, Achenbach syndrome and cutaneous metastases.…”

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confidence: 99%