Pachydermodactyly: Case Report and Review of the Literature

Pachydermodactyly is a rare and benign form of acquired digital fibromatosis characterized by the expansion of soft tissue around proximal phalanges and interphalangeal joints. The etiology remains unknown, although it is suggested that repetitive mechanic trauma like the interlacing or rubbing of the fingers can lead to skin thickening. We report a case of a young man with skin thickening around interphalangeal joints and compulsive finger manipulation habit. The histopathology disclosed hyperkeratosis, discrete papillomatosis, mild increase of fibroblasts and dermal mucinosis. The lesions regressed partially, after finger manipulation was stopped.

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“…1,2,8,9 In this patient, the lesions partially regressed after suspending the trauma to the fingers, at 30-day follow-up.…”

Section: Discussionmentioning

confidence: 63%

“…1 Less than 150 cases have been described so far, in four continents. It is more prevalent among adolescents and young males.…”

Section: Discussionmentioning

confidence: 99%

Case for diagnosis

Requena

Miot

Marques

et al. 2014

An. Bras. Dermatol.

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“…Dorsal and/or ventral sides of fi ngers can also be aff ected (23,29,31,94). Distal involvement has also been described aff ecting distal phalanges (37,42,45), as well as metacarpophalangeal joints (16,40), with fi bromatous thickening or rigid nodes (83). Th ese lesions are usually symmetrical (88), but may be asymmetrical to a certain point, varying in the number and extent of aff ected joints on the left and right hand (76,97) or aff ecting only some joints, the so-called localized form of PDD (13).…”

Section: Discussion and Literature Reviewmentioning

confidence: 99%

Pachydermodactyly: a Case Report and Literature Review

Paravina¹,

Stanojević²,

Jovanović³

et al. 2014

Serbian Journal of Dermatology and Venereology

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Pachydermodactyly is a rare, benign form of digital fibromatosis, characterized by asymptomatic and progressive, periarticular and usually symmetrical soft tissue finger swelling, specifically on the lateral aspects of the proximal interphalangeal joints mainly of the second, third, and fourth fingers; it mostly affects young adolescents and is probably due to repeated mechanical injury of the skin (such as repeated clasping or rubbing of crossed fingers), sometimes as a result of obsessive-compulsive disorder, which must be distinguished from obsessive “chewing pads”. This paper presents a male patient aged 19, who presented with first symptoms at the age of 12, and was diagnosed with periarticular hypertrophy: localized soft tissue thickening around the proximal interphalangeal joints of all fingers except the thumbs; slight hypertrophy of the skin; absence of subjective complaints; normal joint function. Dermatological status on admission revealed: symmetrical soft tissue swelling of all fingers of both hands except the thumbs at the level of the proximal interphalangeal joints; normal appearance of the distal parts of all fingers; thickening at the level of the proximal interphalangeal joints, bilateral, almost symmetrical hypertrophy (ulnar and radial) of phalanges of the affected fingers except both index fingers, affecting only the ulnar side. The skin lesions were pain-free on palpation, with homogeneous texture and elastic consistency, freely movable over underlying structures. The affected joints showed no functional deficit. The test results, sonography, radiography and histopathology confirmed our clinical diagnosis-pachydermodactyly. The review of the currently available literature, published between 1973 and 2014, including 99 papers and 160 patients, provided important insight into the characteristics and variations of the disease.

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“…Pakidermodaktili; ellerin iki, üç ve dördüncü parmaklarının proksimal falanksları ve proksimal interfalangeal eklemlerinin laterallerini etkileyen, progresif, asemptomatik yumuşak doku şişliği ile karakterize dijital fibromatozislerin nadir, benign bir formudur (1). Genellikle adolesan erkeklerde kompülsif davranışların sebep olduğu tekrarlayan minör travmaların bir sonucu olarak ortaya çıktığı düşünülmektedir (2).…”

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