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Puffy hand syndrome is an unrecognized complication of intravenous drug abuse. This painless syndrome appears during or after a long period of drug addiction. It involves the hands and sometimes the forearms, and may cause functional, aesthetic and social disturbances when the hand volume is important. Physiopathological mechanisms of the puffy hand syndrome are unclear and include venous and lymphatic insufficiencies, infectious complications and direct toxicity of injected drugs and their adulterants. Low-stretch bandage and elastic garment, usually used in lymphedema treatment, are proposed to treat the puffy hand syndrome.

Resume Introduction Le lymphœdeme du membre superieur est une complication survenant dans 15 a 20 % des cas apres traitement du cancer du sein. La survenue d'un lymphœdeme sans antecedent neoplasique est une situation rare et doit faire rechercher un cancer du sein. Exegese Nous rapportons les cas de deux femmes, âgees de 53 ans et de 67 ans, ayant developpe un lymphœdeme du membre superieur, 18 et 8 mois avant le diagnostic de cancer du sein. Dans les deux cas, l'examen clinique (palpation des seins et du creux axillaire) etait normal. La mammographie etait anormale dans un cas et non contributive dans l'autre. Seule une IRM du sein permettait alors d'evoquer le diagnostic, confirme ensuite par les biopsies. Discussion Un cancer du sein peut se reveler par un lymphœdeme du membre superieur. La recherche d'un cancer du sein est indispensable dans ce contexte meme si l'examen clinique et l'echomammographie ne sont pas contributifs. Dans cette situation, l'IRM du sein est indispensable.

Resume Introduction Les manifestations extradigestives des maladies inflammatoires chroniques de l’intestin (MICI) sont variees. Des lymphœdemes genitaux ont ete decrits en association avec la maladie de Crohn. Observations Nous rapportons les observations de deux femmes, âgees de 57 et 68 ans, presentant un lymphœdeme des membres inferieurs apparus huit et 20 ans apres le diagnostic de MICI (une maladie de Crohn et une rectocolite hemorragique) quiescentes lors du diagnostic. Conclusion Les mecanismes physiopathologiques de cette manifestation extradigestive sont inconnus et l’evolution du lymphœdeme est independante de l’activite de la MICI.

Extra-intestinal manifestations of chronic inflammatory bowel disease (CIBD) are various. Cases of genital lymphedema has previously been reported in Crohn's disease.We report two women aged 57 and 68 years who presented with a lower limb lymphedema 8 and 20 years after a diagnosis of CIBD (Crohn's disease and ulcerative colitis), respectively. At the time of diagnosis of lymphedema, CIBD was asymptomatic.Pathophysiological mechanisms of this rare manifestation are unclear and lymphedema outcome is unrelated to CIBD activity.

Puffy hand syndrome is an unrecognized complication of intravenous drug abuse. This painless syndrome appears during or after a long period of drug addiction. It involves the hands and sometimes the forearms, and may cause functional, aesthetic and social disturbances when the hand volume is important. Physiopathological mechanisms of the puffy hand syndrome are unclear and include venous and lymphatic insufficiencies, infectious complications and direct toxicity of injected drugs and their adulterants. Low-stretch bandage and elastic garment, usually used in lymphedema treatment, are proposed to treat the puffy hand syndrome.

Upper limb lymphedema occurs in 15 to 20% of patients after breast cancer treatment. Upper limb lymphedema without any history of neoplasia is an unusual situation. In this situation, breast cancer should be suspected.We reported two women, 53 and 67 years old, who developed upper limb lymphedema, 18 and 8 months before the diagnosis of breast cancer. In the two cases, clinical examination (breast and axillary palpation) was normal. In one case, mammography led to the diagnosis and in the other breast MRI was required to confirm the cancer.Upper limb lymphedema may be the presenting clinical feature of breast cancer. Breast cancer should be actively sought despite normal clinical and radiological findings. Breast MRI is required in this situation.