What is Russell's sign?

• A. Calluses on the back of the hands or knuckles from repeated vomiting.
• B. A fear of gaining weight despite normal appetite.
• C. A craving for sweets after meals.
• D. Nighttime eating without awareness.

Answer: (A)

Russell's sign is the physical marker of self-induced vomiting: calluses or scarring on the back of the hands or knuckles from repeated contact with the teeth during vomiting. This finding signals purging behavior and is commonly associated with bulimia nervosa. The other options describe different eating-disorder features rather than a sign of purging: a fear of gaining weight despite normal appetite points to anorexia nervosa; a craving for sweets after meals isn’t a defining sign; nighttime eating without awareness refers to nocturnal eating or binge-eating patterns without the purge marker. Recognizing Russell's sign helps clinicians assess for purging, evaluate related medical risks like electrolyte disturbances and dental erosion, and plan appropriate treatment and safety measures.