Factitious blue edema: a case report

Blue edema or factitious edema is an edema located in a finger, a hand or an entire limb, induced by voluntary stricture by a tourniquet. It is spectacular in its appearance but benign in its evolution. We report a case initially suspected of phlegmon of the right upper limb and which finally turned out to be factitious edema. A 14, year-old girl presenting for a painful swelling of the left upper limb, going up to the arm and evolving for a week. On clinical examination, we noted an impressive edema of the left upper limb predominantly in the hand, with fingers blocked in half-flexion. Edema had a purplish color with thin and scaly skin on the dorsal side of the hand. We suspected a problem of infectious or vascular origin, and completed by biological and radiological explorations without abnormalities. The patient was admitted and improved under broad-spectrum antibiotic therapy, but the appearance of the same symptoms in the contralateral limb, with a careful examination of the integuments of the upper limb noting a mark of strangulation in the middle of the right arm, allowed the diagnosis of factitious blue edema.