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Updated: May 9, 2026

Utility of Dissociated Intrinsic Hand Muscle Atrophy in the Diagnosis of Amyotrophic Lateral Sclerosis
Published on: March 4, 2014
[Comorbid puffy hand syndrome and factitious disorders: an unusual association with poor prognosis]
C Courtin1, L Mathieu, F Rongiéras
1Service de Chirurgie Orthopédique et Traumatologique, Hôpital D'instruction des Armées Desgenettes, 108 Boulevard Pinel, 69275 Lyon Cedex 03, France.
Abstract:
The authors report an original clinical presentation of factitious disorders of the upper extremity in an ex-drug-addict patient with puffy hand syndrome. Chronic self-inflicted ulcerations appeared with sequential manner. The patient confessed deliberate self-harm and transfer of anxiety on his hands, the aspect of which had become intolerable. Association of puffy hand syndrome with comorbid psychosis and major depression explained immediate recurrence of ulcerations despite fitted medication and long-term psychotherapy.
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