A Case of Pachydermodactyly

Hee-Sun Kim; Jae-Bum Jun; Chan-Guem Park; Chang Woo Lee; Kyoung-Bin Joo

doi:10.4078/jkra.2008.15.1.92

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Kim, Jun, Park, Lee, and Joo: A Case of Pachydermodactyly

Original Article

J Korean Rheum Assoc 2008;15(1):92-95.

Published online: 20 March 2008

DOI: https://doi.org/10.4078/jkra.2008.15.1.92

A Case of Pachydermodactyly

Hee-Sun Kim, M.D., Jae-Bum Jun, M.D., Chan-Guem Park, M.D.^∗, Chang Woo Lee, M.D.^∗∗, Kyoung-Bin Joo, M.D.^∗∗∗

Division of Rheumatology, Department of Internal Medicine, The Hospital for Rheumatic Diseases, Seoul, Korea

^∗Department of Pathology, Hanyang University College of Medicine, Seoul, Korea

^∗∗Department of Dermatology, Hanyang University College of Medicine, Seoul, Korea

^∗∗∗Department of Radiology, Hanyang University College of Medicine, Seoul, Korea

Received 24 November 2007 Accepted 22 February 2008

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Pachydermodactyly, Knuckle pads, Pachydermoperiostosis

References

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Fig. 1.

Hand picture showed symmetrical fusiform swellings around the proximal interphalangeal joints.

Fig. 2.

Hand X-ray showed soft tissue swelling around the proximal interphalangeal joints and normal underlying bone.

Fig. 3.

Magnetic resonance imaging showed fusiform soft tissue swelling around the proximal interphalangeal joints without joint effusion, synovial hypertrophy, and bony abnormality.

Fig. 4.

(A) H-E stain showed reticular dermis thickened by deposit of collagen (×100). (B) Alcian blue stain showed deposition of mucin (×100).

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