Articles

Factitious Lymphedema of the Hand

Abstract

Objective: To report the case of a 39- year old unmarried female with factitious edema of the right hand two weeks after being struck by her brother and following self injury of the right arm.
Method: A 39-year old unmarried female with severe edema of the right hand and forearm diagnosed as factitious lymphedema was admitted to Roozbeh Psychiatric Hospital. After hospitalization, with elevation of affected limb, the edema had lessened. Thereafter, she was observed at ward rounds with a cloth bandage wrapped around her arm. The edema had recurred. Physical Examination as well as right upper extremity X ray was normal. In mental state examination, patient's mood was dysphonic, rather anxious, and denied tourniquet application; otherwise no prominent psychiatric symptoms were detected. Patient underwent psychotherapy and 20 my fluoxetetine on daily basis was administered.
Results: Patient's symptoms relieved within eight weeks and discharged while accepted to adjust herself with the situations.
Conclusion: Factitious etiology may be presuming in any patient with unilateral limb lymphedema when venous or lymphatic Pathology were missing. The patient may be suffering from emotional conflicts.

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th text revision ed. Washington, DC: American Psychiatric Association; 2000.

Al-Qattan MM. Factitious disorders of the upper limb in Saudi Arabia. J Hand Surg [Br] 2001; 26: 414-421.

Krahn LE, Li H, O'Connor MK. Patients who strive to be ill: factitious disorder with physical symptoms. Am J Psychiatry 2003; 160: 1163- 1168.

Smith RJ. Factitious lymphedema of the hand. J Bone Joint Surg Am 1975; 57: 89-94.

Firoozabadi A, Taghavi M, Mozafarian K. Psycho-flexed hand Associated with Conversion Reaction: A case Report. Iran J Med Sci 2006; 31: 499-502.

Limosin F, Loze JY, Rouillon F. [Clinical features and psychopathology of factitious disorders]. Ann Med Interne (Paris) 2002; 153: 499-502.

Eisendrath SJ. Factitious physical disorders: treatment without confrontation. Psychosomatics 1989; 30: 383-387.

Friedman B, Yaffe B, Blankstein A, Rubinstein E, Rieck J. Self-inflicted hand injuries: diagnostic challenge and treatment. Ann Plast Surg 1988; 20: 345-350.

Bhugra D. Psychiatric Munchausen's syndrome. Literature review with case reports. Acta Psychiatr Scand 1988; 77: 497-503.

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IssueVol 1 No 4 (2006) QRcode
SectionArticles
Keywords
Etiology Factitious disorders Lymphedema

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How to Cite
1.
Ahmadi Abhari SS, Alimalayeri N, Ahmadi Abhari SA, Omidi Nobijari K. Factitious Lymphedema of the Hand. Iran J Psychiatry. 1;1(4):166-168.