Factitious Lymphedema of the Hand

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.