Localized Hypertrichosis after Index Finger Revascularization and Complex Regional Pain Syndrome

603 skin blood circulation, sweating, edema, and trophic disturbances of the skin, joints, and bones are typical and not limited to the region of the peripheral nerves. CRPS II (causalgia) appears following a partial peripheral nerve lesion, but the symptoms are identical [1]. Regarding the pathogenetic mechanism involved in CRPS, no consensus exists, but traumarelated cytokine release, neurogenic inflammation, sympathetically maintained pain, and cortical reorganization in response to chronic pain seem to play a key role in the development and maintenance of this complex pain syndrome [2]. We describe a patient who developed a mild form of CRPS with an evident localized hypertrichosis on the hand and forearm after subtotal amputation and revascularization of the distal phalanx of the index finger. A 26-year-old woman presented with a traumatic subtotal amputation of the distal phalanx of the right index finger caused by a woodworking machine. Under general anesthesia, two crossed Kirschner wires were used for bony fixation, and for revascularization, the proper digital artery supplying the ulnar side and two dorsal veins were repaired. Both digital nerves were intact. The immediate postoperative course was uneventful, but on the third postoperative day, a thrombosis of the reconstructed artery occurred, which required surgical revision. Under general anesthesia and continuous brachial plexus blockade, reconstruction and revascularization were performed by interposition of a vein graft from the forearm. Continuous brachial plexus blockade for increased blood flow to the injured extremity and postoperative pain management were retained for 5 days. Postoperatively, the index finger was dressed with gauze and a simple hand bandage. Occupational therapy was started 2 weeks postoperatively. About 5 weeks after surgery, the patient presented Various skin changes have been described in complex regional pain syndrome (CRPS), but the association of hypertrichosis with finger replantation has not been described in literature. CRPS occurs as the inadequate response to painful trauma in a distal extremity. Clinically, two types of CRPS can be differentiated according to the preceding noxious event without (CRPS I) or with (CRPS II) an obvious nerve lesion [1]. CRPS I (sympathetic reflex dystrophy) is characterized by sensory disturbances, burning deep spontaneous pain, and allodynia. Disturbances in the Localized Hypertrichosis after Index Finger Revascularization and Complex Regional Pain Syndrome