Leprosy simulating systemic sclerosis: a case report

Chu, Bruna Burko Rocha; Gobbo, Giorgina Falcão Brandão Côrtes; Copês, Rafaela Martinez; Gutjahr, G; Cossa, Erick Cavalcanti; Paiva, Eduardo dos Santos

doi:10.1016/j.rbre.2016.09.010

Cited by 1 publication

(2 citation statements)

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“…7 Skeletal tuberculosis may also be considered given our endemic setting and the patient's clinically-diagnosed pulmonary tuberculosis; it can cause arthritis, osteomyelitis, and sometimes acro-osteolysis with reactive sclerosis. 8 Leprosy may also present with resorption of distal phalanges as reported by Chu et al (2017). 9 Skeletal tuberculosis and leprosy were ruled out with the absence of AFB on skin smear and biopsy.…”

Section: Discussionmentioning

confidence: 96%

“…8 Leprosy may also present with resorption of distal phalanges as reported by Chu et al (2017). 9 Skeletal tuberculosis and leprosy were ruled out with the absence of AFB on skin smear and biopsy. Baer et al (2012) showed that a poorly controlled type I diabetes mellitus can also cause shortening of fingersradiographically described as resorption of the distal phalanx of the left little finger and loss of bone in the distal phalanx of the right little finger.…”

Section: Discussionmentioning

confidence: 96%

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Acro-osteolysis in a Filipino Male with Vinyl Chloride Exposure: A Case Report

2022

Acta Med Philipp

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Occupational acro-osteolysis pertains to bone resorption of the distal phalanges of the hands and feet among workers with vinyl chloride exposure. We report the case of a Filipino man with osteolysis of the distal phalanges of the hands initially considered to have systemic sclerosis. The patient had gradual shortening of the fingers, thickening of the skin over the extremities, and hypopigmented patches over a span of more than 20 years. His lower extremities presented with non-pitting edema, skin thickening, and neuropathy, without shortening of the digits. Difficulty of ambulation was apparent due to the development of feet inversion. Radiographic findings of the hands and feet included resorption of distal phalanges, erosive and sclerotic changes, and narrowed joint spaces. Other conditions considered were Hansen's disease, skeletal tuberculosis, and diabetic neuropathic arthropathy, which were eventually ruled out. The final diagnosis was occupational acro-osteolysis secondary to vinyl chloride exposure. The patient underwent serial total contact casting of the bilateral lower extremities to relieve bipedal edema and to reposition the feet. This case emphasizes the significance of investigating a patient's occupational history and highlights a rare sequela of exposure to a commonly used chemical agent in the manufacture of polyvinyl chloride products.

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