Secrétan's disease: a unique case report and literature review.

Secrétan's disease was first described in 1901 as "hard edema and traumatic hyperplasia of the dorsum of the metacarpus." Other names for this process include peritendinous fibrosis, posttraumatic hard edema, and factitious lymphedema. Over the years, many theories have been proposed as to the etiology of the disease--trauma that leads to peritendinous fibrosis, hypersympathetic stimulus after an injury, and self-inflicted trauma. There is no consensus regarding pathophysiology, classification, prognosis, or treatment, but the literature suggests that Secrétan's disease is an injury that is self-inflicted either for secondary gain or as a conversion reaction and that is best treated with conservative care and psychiatric counseling. Our case report is unique in that our patient had an unusual presentation, underwent an upper extremity sympathectomy before developing Secrétan's disease, and returned to work soon after surgery.