Acropaquias: del signo a la enfermedad / Acropachy: From sign to disease

RESUMEN Las acropaquias, también llamadas dedos en palillo de tambor, se presentan como un aumento de la convexidad ungueal sobre una falange distal engrosada. Su origen es multifactorial, siendo la causa más frecuente las neoplasias, aunque también puede ser idiopático. Pueden encontrarse de forma aislada o formando parte de la osteoartropatía hipertrófica. La importancia de su diagnóstico radica en la alta frecuencia de enfermedad maligna subyacente, por lo que debe ser rápido y exhaustivo. Presentamos 2 casos de pacientes con acropaquias asociados a neoplasia subyacente.

ABSTRACT Acropachy, also called clubbed fingers, presents as increased nail convexity over a thickened distal phalanx. Its origin is multifactorial, with the most frequent cause being neoplasms, although it can also be idiopathic. They can be found in isolation, or as part of hypertrophic osteoarthropathy. The importance of its diagnosis lies in the high frequency of underlying malignant pathology, so it must be rapid and comprehensive. Two cases are presented of patients with acropachy associated with underlying neoplasia.

A Case of Graves' Disease Showing a Triad of Ophthalmopathy, Pretibial Myxedema and Thyroid Acropachy / 대한피부과학회지

Graves' disease is an autoimmune disorder of the thyroid gland and the most common cause of hyperthyroidism. Classic clinical findings include ophthalmopathy (exophthalmos), dermopathy (pretibial myxedema) and thyroid acropachy. The triad of Graves' clinical findings occurs in less than 1% of Graves' patients. We present a case of Graves' disease with the clinical triad of exophthalmos, pretibial myxedema, and thyroid acropachy.

Thyroid Acropachy / 대한정형외과학회잡지

Thyroid acropachy is a rare complication of Graves' disease, manifested by clubbing of the terminal phalanges, periosteal new bone formation and overlying soft tissue swelling, It may occur when the patient is hypothyroid, euthyroid or hyperthyroid. In most cases, it is a part of the syndrome, including exophthalmos and/or pretibial myxedema. The authors have experienced one case of thyroid acropachy and report with a review of the literature review. The patient a 56-year-old female with a characteristic feathery new bone formation on the medial side of the shaft of the left first metatarsal bone and overlying soft tissue swelling. However, there was no pretibial myxedema and clubbing of fingers. She was hypothyroid and treated with systemic corticosteroid for mild pain and persistent swelling. The treatment had temporarily improved the patient's condition.