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The Mystery of the Purple Finger: What Could Have Caused It?

By HERWriter
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purple finger mystery: what caused it? Dmitry Shabanov/PhotoSpin

I looked at my middle finger and was surprised to see the intensity of the purple color of my skin. I tried to think, what could have caused this purple episode to occur in a single finger? Was it serious?

The previous night I had a sudden pain, like an insect had stung me, on the back of my middle finger. I could not see any bite but went ahead and iced it a couple times before bed.

The next day I forgot about my finger, until I noticed it while washing my hands. The skin of my middle finger was incredibly purple like it was bruised or had been dipped in grape jelly.

The odd thing was, only the backside of my middle finger from one knuckle down from the tip to the base was purple. The inside skin of the finger looked normal. The finger did not appear swollen and barely was painful when I squeezed it. I did not have any other symptoms of feeling poorly.

Like many of you would do in this situation, I searched the web. Interestingly, I found numerous forum postings from people who described similar situations that had happened to them. Like me, some of them also had their middle finger affected.

After much hunting, I found a few medical articles that described what it could be and found a photo of someone else’s hand that looked surprisingly like mine. (1)

The diagnosis was a paroxysmal finger hematoma or Achenbach syndrome. Even though it is supposed to be uncommon, based on the numbers of people who posted about similar episodes, it may happen more often than the medical community thinks.

Achenbach syndrome is a benign self-limiting condition of sudden unexplained bruising of the hand or fingers. It is more common in women then men and the middle and index fingers are most affected.

Typically the palm side of the finger shows the bruising after a sudden episode of pain or itching, and there maybe swelling and coldness of the area. The fingertip is usually not involved. The bruising resolves in a few days, which mine did.

While I was able to determine what my purple finger was probably caused by, there are several more serious problems that can cause purple fingers or toes.

Purple digits can be caused a range of problems such as trauma to the finger, a snake bites, a blood clot in the finger due to high levels of cholesterol, or from a cardiac issue. Sensitivity to cold may be due to Raynaud’s disease, frostbite, certain types of anemia or an early sign of lupus.

It is important to consider any issues in your medical history or medications you are taking that might cause a purple finger or toe to occur. Do not be afraid to call or see your doctor.


1) Photo of hand with Achenbach syndrome. Brown, Patrick et al. The Purple Digit: An Algorithmic Approach to Diagnosis. Am J Clin Dermatol. 2010;11(2):103-116. Medscape.com. Retrieved July 28, 2014.

2) Y. Smulders. What about this finger? Department of Internal and Cardiovascular Medicine, VU University Medical Center, Amsterdam, the Netherlands, tel.: +31 (0)20-4444309, fax: +31(0)20-4444313, e-mail: ]]>[email protected]]]>.

3) Brown, Patrick et al. The Purple Digit: An Algorithmic Approach to Diagnosis. Am J Clin Dermatol. 2010;11(2):103-116. Medscape.com. Retrieved July 28, 2014.

4) Kämpfen, S. et al. A Painful Blue Thumb: A Case of Achenbach's Syndrome. Hand Surgery Unit, Department of Reconstructive Surgery, University Hospital, Geneva, Switzerland. Accepted 5 July 2005, Available online 15 September 2005. DOI: 10.1016/j.ejvsextra.2005.07.004.

Michele is an R.N. freelance writer with a special interest in woman’s healthcare and quality of care issues. Other articles by Michele are at http://contributor.yahoo.com/user/499625/michele_blacksberg.html

Edited by Jody Smith

Add a Comment27 Comments

EmpowHER Guest

I've had this on and off since my teens, although the earlier incidents may have been normal teenage trauma/contusion and/or nutrition provocations. I'm male--Achenbach's is usually female--in my late 60's.
The incidents are mild and I notice the discoloration only because of the accompanying stinging (also mild). I also have Reynauds syndrome, commonly associated with the syndrome.

Sometimes there is a provoking pressure incident, but almost always not severe pressure. Some 99% of manual labor does not not provoke these hematomas, including really hard gripping and or shear tension on the fingers, such as gripping a screwdriver and turning a stuck bolt for example: that causes no problems. If memory serves, it's something grabbed onto that has a slight give to the surface, such as a rubbery-surfaced handle.

January 19, 2019 - 11:19am
EmpowHER Guest

I have been searching these symptoms for years and this is the first time I’ve come up with a named syndrome! It is a relief - I thought I was crazy! Even doctors didn’t understand when I described it. It seems to be a minor nuisance at this point.

August 10, 2018 - 3:00pm
EmpowHER Guest
Anonymous (reply to Anonymous)

I have had the same problem and because it comes on so rapidly and disappears so quickly I have never sought medical advice. I too am happy that it does have a name and is not something that I have made up.

August 30, 2018 - 12:41pm
EmpowHER Guest

I get this in my thumb joint or finger joint. I think Achenbach syndrome is much more common than the medical literature believes it to be. In all my cases, it has occurred after some physical activity, such as shopping or cooking. I have never experienced this while sleeping or resting. I have found raising one's hand above one's head immediately at the onset of the prickling & swelling sensation reduces the symptoms and bruising a somewhat.

July 30, 2018 - 3:03am
EmpowHER Guest

I'm amazed that a Google search on, 'unexplainable, sudden and painful finger bruises' would actually have any results, lol. This just happened to me again, as it does about every month or so and comes out of nowhere. It always happens on the back palm side or the side of the finger, usually, but not always on the lower finger joint, but never on the topside of the finger. It really feels just like a wasp sting as it builds up to a creschendo of pain. As others have stated, it also itches like hell, but if you were to scratch it, it would be like getting stung all over again. Yes, the bruise soon appears in a greenish blue, or cyan color.

May 1, 2018 - 4:31pm
EmpowHER Guest

I have this too! It probably only happens maybe a couple of times a year and I don't think I've ever thought too much about it.
That was until it happened again last Sunday. I was just pottering in the kitchen, not doing anything strenuous when when I suddenly felt a very sharp pain and it almost felt like something 'twanged' in my index finger which then went very hot and itchy. Within about 5 minutes, what looked like a bruise or blood blister started to develop under the skin. By the evening it was very dark purple bruise but limited to the top joint of my index finger. This made me Google it to see what could have caused it, which brought me to this article. Very interesting to read what it might be.
As I've said, maybe have a couple of episodes like this twice a year and think I have had them for about 10 years of so.

May 9, 2017 - 8:52am
EmpowHER Guest
Anonymous (reply to Anonymous)

I have been having these same purple fingers for 40 yrs! the rheumatologist told me they were hives. I also have rheumatoid arthritis and Raynauds disease. i wonder if they are related. Glad to know i'm not crazy after all!

September 6, 2017 - 1:01pm
HERWriter Guide (reply to Anonymous)

Hi Anon!

Raynaud's Disease is indeed a cause of these purple fingers. Mystery solved! 


September 6, 2017 - 3:30pm
EmpowHER Guest
Anonymous (reply to SusanC)

Reynaud syndrome is not bruising. The fingers go white, no circulation.

December 17, 2019 - 8:31pm
EmpowHER Guest
Anonymous (reply to SusanC)

Not Raynaud's disease in my case, nor that of others, based upon the comments. You even stated that this was, 'A' (possible), cause and not 'THE' (only) cause, yet you end with, 'mystery solved'? If you search Raynaud's Disease in Google Images, you will see large percentages of the hand that turn purple or white, which is not what people here are describing.

May 1, 2018 - 4:51pm
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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.