Tropical Diabetic Hand Syndrome—Report of 2 Cases

Tropical diabetic hand syndrome (TDHS) is not a commonly reported complication of diabetes mellitus. It was first reported in Nigeria in 1984[1] but prior to that time, in 1977, it was described in the United States of America.[2] Several other cases are now being reported in other countries of Africa and India. It is termed TDHS because it affected patients with diabetes mellitus in the tropics. It presents with cellulitis, ulceration, and fulminant sepsis of the hand, which may progress to gangrene, and many have lost the digits as seen in one of our patients or sometimes the whole hand. Many of these patients present very late as the onset of the condition is usually due to minor trauma to the hand like a pin prick or little scratches, which result in cellulitis are treated by patent medicine dealers until the sepsis and possibly gangrene in some cases sets in.