Ainhum, a rare mutilating dermatological disease in a female Cameroonian: a case report.

BACKGROUND: Ainhum is an idiopathic dermatological disease characterized by a progressive constricting ring usually on the fifth toe, which may lead to spontaneous auto-amputation of the affected toe. Timely diagnosis and treatment are the key elements to avert amputations with resultant mutilating deformities, permanent handicaps and psychological sequelae. Though common in African descents, this pathology has not been described in the Cameroonian literature. Herein, we report the case of an adult Cameroonian woman presenting with ainhum. CASE PRESENTATION: A 54-year old Cameroonian was admitted to our primary healthcare centre with a 6-month history of a painful constriction band developing at the base of her right fifth toe. Her past history was uneventful. Based on the absence of trauma and spontaneous onset of the condition, the diagnosis of ainhum was most suggestive. She was managed surgically by excision of the band, disarticulated at right fifth metatarsophalangeal joint and skin closure. Her post-operative course after 1 year was uneventful. CONCLUSION: Here we presented a case of ainhum, a rare dermatological disease with few reports. In view of the serious complications of ainhum such as mutilating deformities with permanent physical disabilities and psychological trauma, we draw clinicians' attention, especially wound care specialists to this rare but potentially handicapping disease, for timely diagnosis and management.

Hanging on by a thread: a rare case of secondary pseudoainhum.

Pseudoainhum is a rare and poorly characterised phenomenon involving autoamputation of a digit associated with an identifiable or related disease process. We describe the case of a 19-year-old man with long-standing neurodisability, sensorineural hearing loss and severe keratoderma, presenting with painless rapidly-progressing autoamputation of his left little toe. Genetic analysis thus far has been inconclusive. The toe appeared to be hanging on by a thread, with no clinical signs of infection. Radiographs showed lysis with complete resorption of the proximal phalynx. Routine blood tests found an isolated neutropenia with normal C reactive protein and biochemistry. We report an unusual case of a young adult with a history of chronic neurological and dermatological problems presenting with secondary pseudoainhum and provide a valuable addition to the limited literature describing this rare condition.

Ainhum (dactylolysis spontanea): a case with hands and feet involvement.

Dactylolysis spontanea is a rare disease of unknown etiology, basically restricted to digits without systemic involvement. It evolves, in the form of a local constriction, affecting typically the distal phalanx of the fifth toe, rarely involving other toes and even more rarely involving fingers as in the case described herein.

Pseudoainhum in acute psoriasis.

The term Pseudoainhum is used in medical literature to elaborate the presence of constricting bands around the digits of hands and feet due to variety of etiologies. This phenomenon can lead to irreversible damage to the supplying neurovasculature and sequential autoamputation of the affected digits. The report herein, describes the rare presentation of pseudoainhum occurring concomitantly in acute psoriasis. Timely recognition of such rare disease entities by physicians is imperative to avoid unnecessary complications.

Dactilosis espontánea (ainhum): informe de un caso / Spontaneous Dactilosis (ainhum): case report

Se muestran los resultados de un estudio de caso diagnosticado como dactilosis espontánea (ainhum) en paciente joven, que evoluciona hace alrededor de 10 años. Se diagnostica la enfermedad en el paciente a través de resultados de interrogatorio, examen físico y estudios anatomopatológicos. Se realiza tratamiento quirúrgico de lesión y se realiza seguimiento del paciente mejorado por consulta dermatológica (AU)

An unusual cause of ulceration: ainhum (dactylolysis spontanea).

We describe a case of ainhum, a mutilating condition, usually seen in peoples of West African origin. A patient presented at the Diabetic Foot Clinic, Kings College Hospital, with a painful infected ulcer between the fourth and fifth toe of his right foot. He was a 43-year-old Nigerian and did not have diabetes. He reported that his left fifth toe had autoamputated some months before. Radiograph of the right fifth toe showed absorption of the proximal and intermediate phalanges, and a diagnosis of ainhum was made. Ainhum or dactylolysis spontanea is a rare condition of unknown aetiology in which a groove or fissure of constricting tissue forms around the proximal end of the fifth toe. Eventually, the groove extends to encircle the toe, the underlying structures are absorbed and the toe autoamputates. It may present as chronic fissuring at the base of the fifth toe or as foot ulceration. This condition is seldom seen in the United Kingdom, but it is likely that this condition is underdiagnosed. It is important that wound care specialists be aware of the diagnosis.

Destructive deformation of the digits with auto-amputation: a review of pseudo-ainhum.

Pseudo-ainhum is an auto-amputation of the digits. Although extremely rare, it is a traumatic and painful experience that can be alleviated with early recognition and intervention. The scientific literature is filled with reports of this interesting but unfortunate phenomenon. To date, a firm causative aetiology has not yet been established. Although reports on this phenomenon have attempted to further our understanding of pseudo-ainhum, a clear understanding has been complicated by the interchangeable use of terms describing this auto-amputation. In this review, we discuss the current understanding, diagnostic criteria, and management of pseudo-ainhum. Furthermore, the nomenclature of pseudo-ainhum is clarified. Ideally, this will allow for more efficient exploration of pseudo-ainhum, its causes, and therapeutic approaches.

Dactylolysis spontanea or ainhum involving the big toe.

We describe the case of an Italian Caucasian man with ainhum involving both big toes. Ainhum or dactylolysis spontanea is characterized by the development of a constricting band around a toe, which progresses to spontaneous autoamputation. It usually affects the fifth toe bilaterally, but in rare cases other toes may be involved. The disease occurs in Black people living in tropical regions but occasionally has been reported in persons having fair skin.