Russell's sign

Russell's sign
SpecialtyPsychiatry, clinical psychology
CausesThe most common causes of Russell’s sign are bulimia, purging disorder, and anorexia nervosa.
Differential diagnosisIndirect sign of bulimia nervosa, purging disorder, or anorexia nervosa

Russell's sign, named after British psychiatrist Gerald Russell, is a sign[1] defined as calluses on the knuckles[2] or back of the hand due to repeated self-induced vomiting over long periods of time. The condition generally arises from the patient's knuckles making contact with the incisor teeth during the act of inducing the gag reflex at the back of the throat with their fingers.[3]

This type of scarring is considered one of the physical indicators of a mental illness, and Russell's sign is primarily found in patients with an eating disorder such as bulimia nervosa, purging disorder, or anorexia nervosa. It is almost always associated with eating disorders and is the most characteristic skin condition indicative of purging.[2][4]

People who are capable of "handsfree purging", or the induction of vomiting by the willful opening of the esophageal sphincter in a manner similar to belching, while contracting the stomach muscles, do not have Russell's sign. People who use a fork, spoon, or foreign object to stimulate the gag reflex may not display Russell's sign.[citation needed]

References

  1. ^ Tyler I, Birmingham CL (November 2001). "The interrater reliability of physical signs in patients with eating disorders". Int J Eat Disord. 30 (3): 343–5. doi:10.1002/eat.1094. PMID 11767717.
  2. ^ a b Strumia R (2005). "Dermatologic signs in patients with eating disorders". Am J Clin Dermatol. 6 (3): 165–73. doi:10.2165/00128071-200506030-00003. PMID 15943493. S2CID 42761798.{{cite journal}}: CS1 maint: deprecated archival service (link)
  3. ^ Glorio, Roberto; Allevato, Miguel; De Pablo, Ana; Abbruzzese, Mario; Carmona, Luz; Savarin, Mario; Ibarra, Monica; Busso, Corina; Mordoh, Ana; Llopis, Carolina; Haas, Roxana; Bello, Mabel; Woscoff, Alberto (2000). "Prevalence of cutaneous manifestations in 200 patients with eating disorders". International Journal of Dermatology. 39 (5): 348–353. doi:10.1046/j.1365-4362.2000.00924.x. ISSN 0011-9059. PMID 10849124.
  4. ^ Manoharan, Senthil Vel Rajan Rajaram; Behere, Rishikesh V.; Praharaj, Samir Kumar; Kongasseri, Sreejayan; Sharma, P.S.V.N. (2014). "Russell's Sign in Persistent Delusional Disorder: A Case Report". The Journal of Neuropsychiatry and Clinical Neurosciences. 26 (3): E4–E5. doi:10.1176/appi.neuropsych.13060127. PMID 25093783.


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