ABSTRACT
Pachydermodactyly (PDD) is a rare, benign form of digital fibromatosis that is characterized by asymptomatic soft tissue swellings on the back and side of the proximal interphalangeal joint areas of the fingers. We report three cases of young male patients who presented with bilateral swelling of the fingers. Histopathologic examination showed epidermal hyperplasia with acanthosis and hyperkeratosis. Collagen fibers in the reticular dermis were thickened and irregularly arranged, and deposition of mucin in the dermis was observed. Since pachydermodactyly usually affects adolescent males with joint swelling, it is often confused with rheumatologic diseases. Here, we report three cases diagnosed with pachydermodactyly based on clinical manifestations and histopathological examination.
Subject(s)
Adolescent , Humans , Male , Collagen , Dermis , Fibroma , Fingers , Hyperplasia , Joints , MucinsABSTRACT
Pachydermodactyly is a form of digital dermal fibromatosis of unknown etiology, characterized by asymptomatic soft tissue swelling on the lateral aspects of the proximal interphalangeal joints of the hands. It usually affects young men and often associated with repetitive mechanical trauma. As a rule, it is a benign condition and a specific therapy or extensive investigation is not necessary in most cases. However, pachydermodactyly is not well recognized by physician. So it can be confused with other rheumatic conditions, such as rheumatoid arthritis or juvenile idiopathic arthritis. A prompt diagnosis is crucial for preventing inappropriate or possible toxic treatment. We describe a case of pachydermodactyly in a 20-year-old military man, who had painless swellings of the hand joints.
Subject(s)
Humans , Male , Young Adult , Arthritis, Juvenile , Arthritis, Rheumatoid , Diagnosis , Fibroma , Hand , Hand Joints , Joints , Military PersonnelABSTRACT
La paquidermodactilia (pachy: grueso; dermos: piel: dactylos: dedos) es un tipo de fibromatosis digital benigna, patología rara que afecta sobre todo a varones jóvenes. Su etiología no se conoce bien, pero algunos autores defienden los traumatismos repetidos como principal desencadenante. Presentamos el caso de un varón de 16 años con engrosamiento digital difuso en ambas manos de 6 años de evolución, asintomático. El paciente refirió tener un "tic" en las manos; consiste en el roce muy frecuente entre los dedos. Se trata de una patología benigna cuyo diagnóstico es clínico, por lo que no es necesario realizar pruebas adicionales que prolonguen el número de visitas del paciente al hospital y los trastornos que ello conlleva. Se debe hacer hincapié en el control del hábito por parte del paciente, para evitar traumatismos repetidos y lograr la mejoría del cuadro.
Pachydermodactyly is a type of benign digital fibromatoses, a rare condition that affects mostly young men. The cause is unknown but some authors suggest that traumatism can be involved. A 16-year-old man presented with symmetrical painless swellings on the fingers of both hands. He used to rub his fingers together. The control of living habits must be enphasized in order to avoid repeteated injuries. Hence, our consultation work is with the patient and his family. We describe a new case of pathology with a common clinical diagnosis, whose ignorance could lead us to carry out unnecesary tests involving inconvenience to the patient. It is important to emphasize the modification of the patient's living habits in order to achieve its improvement.
Subject(s)
Adolescent , Humans , Male , Fingers , Fibroma/diagnosisABSTRACT
Pachydermodactyly (PDD) is a rare, benign form of digital fibromatosis and this is characterized by asymptomatic soft tissue swelling that affects the lateral aspects of the proximal interphalangeal (PIP) joints of the fingers. Although the etiology of PDD is unknown, the possibility of repetitive minor trauma by habitual or compulsive habits of interlacing the fingers or rubbing of the fingers has been suggested as a cause by several authors. We experienced a 14-year-old boy who was diagnosed as having PDD by the clinical manifestations and this was supported by a radiological study and the routine laboratory tests. He also had the habit of repetitively manipulating his hands when feeling emotional distress. PDD sometimes can be misdiagnosed as a rheumatic condition. Although an unusual disorder, PDD should be considered in the differential diagnosis of patients who present with digital bulbous swelling.
Subject(s)
Adolescent , Humans , Diagnosis, Differential , Fibroma , Fingers , Hand , JointsABSTRACT
Objective To improve the understanding of the clinical features, differential diagnosis and prognosis of pachydermodactyly. Methods The clinical data of 20 patients with pachydermo dactyly and follow-up data of 6 patient were analyzed. Results Seventeen out of 20 patients were male. The average onset age was (15±2) years. All of them had asymptomatic, firm swellings which developed insidiously on both sides of the proximal interphalangeal (PIP) joints. All the patients indicated that they were in the compulsive habit of interlacing their fingers and squeezing them. For all patients, biochemical examinations were normal and there was no rheumatoid factor or antinuclear antibodies. X-ray and MRI showed that the thickening of soft tissue around PIP joints without changes in bones or joints structure. Histopathologic findings from the swellings reveMed marked hyperkeratosis, with slight epidermal hyperplasia, and a markedly thickened dermis with whorled, densely aggregated bundles of coarse collagen. Even though 8 patients in the group had gotten rid of the aforesaid habit for 3 to 22 years, the swellings of their PIP joints did not resolve. Conclusion Pachy-dermodactyly is a benign digital fibromatosis which usually involves the PIP joints. It can be distinguished from juvenile rheumatoid arthritis and knuckle pad.
ABSTRACT
Pachydermodactyly is a kind of benign fibromatosis in which asymptomatic symmetrical soft tissue swellings occur on the proximal phalanges and the proximal interphalangeal joints of the hands. Although young women can also be affected, the young men are affected most commonly. There is no bony or articular abnormality on radiographic study. Histological examination of skin demonstrated epidermal hyperplasia, hyperkeratosis, acanthosis and thickened reticular dermis by deposition of collagen. It is important to recognize this disease identity without misdiagnosis for other rheumatologic diseases to avoid inappropriate and possibly toxic treatments. We report a case of pachydermodactyly and discuss the differential diagnosis.
Subject(s)
Female , Male , Humans , Diagnosis, DifferentialABSTRACT
Pachydermodactyly is a rare, distinct form of digital fibromatosis characterized by acquired, asymptomatic, bulbous swellings on the back and side of the proximal phalanges or proximal interphalangeal joint areas of fingers. It occurs mostly in men. There have been many cases treated with intralesional injection of corticosteroids, however, only a few by surgical excision. We report a case of pachydermodactyly, involving both fingers, in a young female. She was treated with surgical excision and recovered, with no sign of sequelae, during a follow-up period of 6 months.
Subject(s)
Female , Humans , Male , Adrenal Cortex Hormones , Fibroma , Fingers , Follow-Up Studies , Injections, Intralesional , JointsABSTRACT
Pachydermodactyly is a rare, distinct form of digital fibromatosis characterized by acquired, asymptomatic, bulbous swellings on the back and side of the proximal phalanges or proximal interphalangeal joint areas of fingers. It occurs mostly in men. There have been many cases treated with intralesional injection of corticosteroids, however, only a few by surgical excision. We report a case of pachydermodactyly, involving both fingers, in a young female. She was treated with surgical excision and recovered, with no sign of sequelae, during a follow-up period of 6 months.
Subject(s)
Female , Humans , Male , Adrenal Cortex Hormones , Fibroma , Fingers , Follow-Up Studies , Injections, Intralesional , JointsABSTRACT
Pachydermodactyly is a rare distinct form of fibromatosis characterized by acquired, asymptomatic dense fibrosis and fibroblastic proliferation around one or more proximal interphalangeal joints. Intralesional triamcinolone injection may be helpful in improving the clinical appearance. A 20-year-old unemployed female patient gave a four years history of progressive swelling of the fingers affecting predominantly the proximal interphalangeal joints of index fingers of left hand and index, middle fingers of right hand. There was no pain and tenderness. Physical examination, complete blood count, antinuclear antibody, rheumatoid factor were unremarkable and radiograph of both hands showed soft tissue swelling only without bony abnormality. We excised the redundant soft tissue from the both sides of proximal interphalangeal joint with longitudinal elliptical fashion. After operation, the fingers of the patient showed marked improvement cosmetically. There were no motor or sensory changes. Pachydermodactyly was first reported in 1996 in Korea. Histologic features include an increased dermal accumulation of collagen and occasionally an increased number of fibroblast. We report for one patient with pachydermodactyly treated with longitudinal elliptical excision and obtained an improvement of clinical appearance.
Subject(s)
Female , Humans , Young Adult , Antibodies, Antinuclear , Blood Cell Count , Collagen , Fibroblasts , Fibroma , Fibrosis , Fingers , Hand , Joints , Korea , Physical Examination , Rheumatoid Factor , TriamcinoloneABSTRACT
Pachydermodactyly is an uncommon condition in which poorly-circumscribed, symmetrical, soft-tissue swelling occurs on the proximal phalanges and interphalangeal joints of the hands. The condition mostly affects young men. Histopathologically, pachydermodactyly shows hyperkeratosis, acanthosis, mucin formation, a thickened dermis with collagen deposition in irregular bundles and sparse benign fibroblasts. We herein report a typical case of pachydermodactyly in a 17-year-old male, who had soft tissue swelling on the lateral side of both 4th fingers. The lesions were treated with intralesional triamcinolone injections.
Subject(s)
Adolescent , Humans , Male , Collagen , Dermis , Fibroblasts , Fingers , Hand , Joints , Mucins , TriamcinoloneABSTRACT
Objective To study the immunological changes and clinical features of pachydermodactyly.Methods Thirteen cases of pachydermodactyly were studied and the literature about this disease was reviewed.Results The mean disease onset age was (16?3)years,11 of whom were male,2 were female;clinical feature was chronic non-inflammatory bulbous swelling of proximal interphalangeal joints,most of which distributed symmetrically;there were no abnormal results in immunological examination;X-ray showed only soft tissue swelling with no articular or bone damage.Conclusion Pachydermodactyly belongs to rheumatological diseases,and should be differentiated from other arthritis involving PIP joints.
ABSTRACT
Pachydermodactyly is a rare form of digital fibromatosis mostly affecting young men. It is characterized by asymptomatic, protracted, bulbous soft tissue swellings on proximal phalangeal and proximal interphalangeal joint areas of fingers. Histopathologic findings represent hyperkeratosis, acanthosis, and thickening of the dermis due to increased collagen bundles There is also mucin deposition in the dermis. Intralesional infection of steriods is helpful in relieving the skin lesions. We report a case of pacgydermodactyly manifested as soft tissue swellings unilaterally on the lateral aspects of fingers. The lesions showed a good response to triamcinolone intralesional infections.