Journal List > J Korean Soc Surg Hand > v.19(4) > 1106473

J Korean Soc Surg Hand. 2014 Dec;19(4):205-208. Korean.
Published online December 31, 2014.  https://doi.org/10.12790/jkssh.2014.19.4.205
Copyright © 2014. The Korean Society for Surgery of the Hand
A Case of Pachydermodactyly
Chae Chil Lee,1 Seung Won Choi,2 Se Jin Jung,3 Young Min Kim,3 and Il Yeong Hwang1
1Department of Orthopedic Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
2Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
3Department of Pathology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.

Correspondence to: Seung Won Choi. Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunhwan-doro Dong-gu, Ulsan 682-714, Korea. TEL: +82-52-250-7029, FAX: +82-52-250-7048, Email: choisw@uuh.ulsan.kr
Received September 29, 2014; Revised December 02, 2014; Accepted December 02, 2014.

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 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.

Keywords: Pachydermodactyly; Hand joints

Figures


Fig. 1
Photograph of hands shows bilateral soft tissue swellings of the proximal interphalangeal joints.
Click for larger image


Fig. 2
Hand radiograph showings soft tissue swelling around the proximal interphalangeal joints without joint narrowing or bony erosions.
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Fig. 3
Magnetic resonance imaging reveals soft tissue swelling of the second to fourth proximal interphalangeal joints of the hand without articular or bony abnormality.
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Fig. 4
Skin biopsy specimen exhibits marked hyperkeratosis, acanthosis and thickened dermis with collagen deposition (H&E, ×100).
Click for larger image

References
1. Curley RK, Hudson PM, Marsden RA. Pachydermodactyly: a rare form of digital fibromatosis: report of four cases. Clin Exp Dermatol 1991;16:121–123.
2. Fleeter TB, Myrie C, Adams JP. Pachydermodactyly: a case report and discussion of the pathologic entity. J Hand Surg Am 1984;9:764–766.
3. Verbov J. Letter: Pachydermodactyly: a variant of the true knuckle pad. Arch Dermatol 1975;111:524.
4. Al Hammadi A, Hakim M. Pachydermodactyly: case report and review of the literature. J Cutan Med Surg 2007;11:185–187.
5. Anandacoomarasamy A, Bak HS, Peduto A, Manolios N. Magnetic resonance imaging in pachydermodactyly. J Rheumatol 2005;32:2239–2241.
6. Sagransky MJ, Pichardo-Geisinger RO, Munoz-Ali D, Feldman SR, Mora DC, Quandt SA. Pachydermodactyly from repetitive motion in poultry processing workers: a report of 2 cases. Arch Dermatol 2012;148:925–928.
7. Bardazzi F, Neri I, Raone B, Patrizi A. Pachydermodactyly: seven new cases. Ann Dermatol Venereol 1998;125:247–250.
8. Park JH, Lee CW. A case of pachydermodactyly treated by surgical excision. Korean J Dermatol 2006;44:369–371.
9. Martin JC, Rennie JA, Kerr KM. Pachydermodactyly: confused with JCA. Ann Rheum Dis 1992;51:1101–1102.
10. Kim HS, Jun JB, Park CG, Lee CW, Joo KB. A case of pachydermodactyly. J Korean Rheum Assoc 2008;15:92–95.