Bilateral "puffy hands" are a common clinical feature of hepatitis C virus (HVC) infection. A history of intravenous drug use should be explored and location of injections clearly identified. The puffy hands here are those of a former heroin addict with HCV infection. The hand edema begins as pitting edema, followed by thickening and fibrosis of the subcutaneous tissue.
Courtesy of James Studdiford, MD, Kathleen Lamb, Amber Stonehouse, MD.
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