Purple glove syndrome: Difference between revisions
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{{Infobox medical condition | |||
| name = Purple glove syndrome | |||
| synonyms = | |||
| field = [[Neurology]], [[Vascular medicine]] | |||
| symptoms = [[Pain]], [[swelling]], [[discoloration]] of the skin | |||
| complications = [[Compartment syndrome]], [[tissue necrosis]] | |||
| onset = Within hours to days after [[intravenous]] [[phenytoin]] administration | |||
| duration = Variable, can last days to weeks | |||
| causes = [[Intravenous]] administration of [[phenytoin]] | |||
| risks = Use of [[intravenous]] [[phenytoin]], especially in small veins or with improper technique | |||
| diagnosis = Clinical evaluation | |||
| differential = [[Thrombophlebitis]], [[cellulitis]], [[deep vein thrombosis]] | |||
| prevention = Use of [[fosphenytoin]] instead of [[phenytoin]], proper [[intravenous]] administration techniques | |||
| treatment = [[Elevation]] of the affected limb, [[warm compresses]], [[analgesics]], [[surgical intervention]] if severe | |||
| prognosis = Generally good with appropriate management, but can lead to complications if untreated | |||
| frequency = Rare | |||
}} | |||
'''Purple glove syndrome''' (PGS) is a rare but serious complication associated with the intravenous administration of the anticonvulsant drug [[phenytoin]]. It is characterized by the development of painful swelling, discoloration, and sometimes tissue necrosis in the affected limb. | '''Purple glove syndrome''' (PGS) is a rare but serious complication associated with the intravenous administration of the anticonvulsant drug [[phenytoin]]. It is characterized by the development of painful swelling, discoloration, and sometimes tissue necrosis in the affected limb. | ||
==Presentation== | ==Presentation== | ||
Purple glove syndrome typically presents within hours to days after the administration of phenytoin. The affected area, usually the hand or arm, initially shows a purple discoloration, which can progress to more severe symptoms including: | Purple glove syndrome typically presents within hours to days after the administration of phenytoin. The affected area, usually the hand or arm, initially shows a purple discoloration, which can progress to more severe symptoms including: | ||
* Pain and tenderness | * Pain and tenderness | ||
* Swelling | * Swelling | ||
* Blistering | * Blistering | ||
* Tissue necrosis | * Tissue necrosis | ||
==Pathophysiology== | ==Pathophysiology== | ||
The exact mechanism of PGS is not well understood. However, it is believed to be related to the extravasation of phenytoin into the surrounding tissues, leading to local irritation and vascular damage. Factors that may contribute to the development of PGS include: | The exact mechanism of PGS is not well understood. However, it is believed to be related to the extravasation of phenytoin into the surrounding tissues, leading to local irritation and vascular damage. Factors that may contribute to the development of PGS include: | ||
* High pH of phenytoin solution | * High pH of phenytoin solution | ||
* Rapid infusion rates | * Rapid infusion rates | ||
* Use of small veins for administration | * Use of small veins for administration | ||
==Diagnosis== | ==Diagnosis== | ||
Diagnosis of purple glove syndrome is primarily clinical, based on the characteristic appearance of the affected limb and the history of recent phenytoin administration. Imaging studies such as [[ultrasound]] or [[MRI]] may be used to assess the extent of tissue damage. | Diagnosis of purple glove syndrome is primarily clinical, based on the characteristic appearance of the affected limb and the history of recent phenytoin administration. Imaging studies such as [[ultrasound]] or [[MRI]] may be used to assess the extent of tissue damage. | ||
==Management== | ==Management== | ||
Management of PGS involves discontinuation of phenytoin and supportive care. Treatment options may include: | Management of PGS involves discontinuation of phenytoin and supportive care. Treatment options may include: | ||
* Elevation of the affected limb | * Elevation of the affected limb | ||
* Application of warm compresses | * Application of warm compresses | ||
* Pain management with analgesics | * Pain management with analgesics | ||
* Surgical intervention in severe cases, such as fasciotomy or debridement | * Surgical intervention in severe cases, such as fasciotomy or debridement | ||
==Prevention== | ==Prevention== | ||
Preventive measures to reduce the risk of PGS include: | Preventive measures to reduce the risk of PGS include: | ||
* Using alternative routes of administration for phenytoin, such as oral or intramuscular | * Using alternative routes of administration for phenytoin, such as oral or intramuscular | ||
* Administering phenytoin through a central venous catheter | * Administering phenytoin through a central venous catheter | ||
* Slowing the infusion rate and diluting the phenytoin solution | * Slowing the infusion rate and diluting the phenytoin solution | ||
==Related Pages== | ==Related Pages== | ||
* [[Phenytoin]] | * [[Phenytoin]] | ||
| Line 39: | Line 47: | ||
* [[Tissue necrosis]] | * [[Tissue necrosis]] | ||
* [[Anticonvulsant]] | * [[Anticonvulsant]] | ||
==See Also== | ==See Also== | ||
* [[Extravasation (intravenous)]] | * [[Extravasation (intravenous)]] | ||
* [[Compartment syndrome]] | * [[Compartment syndrome]] | ||
* [[Drug-induced skin reactions]] | * [[Drug-induced skin reactions]] | ||
[[Category:Medical conditions]] | [[Category:Medical conditions]] | ||
[[Category:Neurology]] | [[Category:Neurology]] | ||
[[Category:Pharmacology]] | [[Category:Pharmacology]] | ||
{{Medical-stub}} | {{Medical-stub}} | ||
{{No image}} | |||
Latest revision as of 01:06, 4 April 2025
| Purple glove syndrome | |
|---|---|
| Synonyms | |
| Pronounce | N/A |
| Specialty | N/A |
| Symptoms | Pain, swelling, discoloration of the skin |
| Complications | Compartment syndrome, tissue necrosis |
| Onset | Within hours to days after intravenous phenytoin administration |
| Duration | Variable, can last days to weeks |
| Types | N/A |
| Causes | Intravenous administration of phenytoin |
| Risks | Use of intravenous phenytoin, especially in small veins or with improper technique |
| Diagnosis | Clinical evaluation |
| Differential diagnosis | Thrombophlebitis, cellulitis, deep vein thrombosis |
| Prevention | Use of fosphenytoin instead of phenytoin, proper intravenous administration techniques |
| Treatment | Elevation of the affected limb, warm compresses, analgesics, surgical intervention if severe |
| Medication | N/A |
| Prognosis | Generally good with appropriate management, but can lead to complications if untreated |
| Frequency | Rare |
| Deaths | N/A |
Purple glove syndrome (PGS) is a rare but serious complication associated with the intravenous administration of the anticonvulsant drug phenytoin. It is characterized by the development of painful swelling, discoloration, and sometimes tissue necrosis in the affected limb.
Presentation[edit]
Purple glove syndrome typically presents within hours to days after the administration of phenytoin. The affected area, usually the hand or arm, initially shows a purple discoloration, which can progress to more severe symptoms including:
- Pain and tenderness
- Swelling
- Blistering
- Tissue necrosis
Pathophysiology[edit]
The exact mechanism of PGS is not well understood. However, it is believed to be related to the extravasation of phenytoin into the surrounding tissues, leading to local irritation and vascular damage. Factors that may contribute to the development of PGS include:
- High pH of phenytoin solution
- Rapid infusion rates
- Use of small veins for administration
Diagnosis[edit]
Diagnosis of purple glove syndrome is primarily clinical, based on the characteristic appearance of the affected limb and the history of recent phenytoin administration. Imaging studies such as ultrasound or MRI may be used to assess the extent of tissue damage.
Management[edit]
Management of PGS involves discontinuation of phenytoin and supportive care. Treatment options may include:
- Elevation of the affected limb
- Application of warm compresses
- Pain management with analgesics
- Surgical intervention in severe cases, such as fasciotomy or debridement
Prevention[edit]
Preventive measures to reduce the risk of PGS include:
- Using alternative routes of administration for phenytoin, such as oral or intramuscular
- Administering phenytoin through a central venous catheter
- Slowing the infusion rate and diluting the phenytoin solution
