An Update On Pachydermodactyly and a Report of 3 Additional Cases

Pachydermodactyly is a benign condition characterized by symmetrical, painless, diffuse swelling of the skin on the lateral aspects of the proximal interphalangeal joints of the fingers. Histopathological examination shows epidermal hyperplasia, an increase of dermal collagen bundles and a slightly increased number of fibroblasts. We report three adolescent males with pachydermodactyly. We also review 20 published cases, and discuss the differential diagnosis, clearly distinguishing pachydermodactyly from 'true' and 'false' knuckle pads

Coxins interfalangeanos sobre paquidermodactilia Interphalangeal pads on pachydermodactyly

Coxins interfalangeanos são nodulações ceratósicas, de limites precisos, com aproximadamente um centímetro de diâmetro, geralmente sobre as articulações interfalangenas das mãos. A paquidermodactilia é uma tumefação uniforme da pele que ocorre nas falanges proximais das mãos. É relatado o caso de um jovem com associação de paquidermodactilia e coxins interfalangeanos, fato não encontrado na literatura médica. Embora haja descrição que considera serem essas manifestações diversas da mesma doença, acredita-se que sejam entidades distintas. O ato compulsivo de atritar a pele parece ser o denominador comum mais aceito para justificar as duas doenças. Os autores postulam que o coxim interfalangeano seria uma resposta epidérmica, enquanto a paquidermodactilia, uma resposta dérmica a um mesmo fator traumático sobre a pele. O paciente foi tratado com infiltração intralesional de triancinolona, com melhora clínica expressiva das duas manifestações.<br>Knuckle pads are keratotic nodulations within precise limits and approximately one centimeter in diameter, usually on the interphalangeal joints of the hands. Pachydermodactyly is a uniform swelling of the skin occurring in the proximal phalanges of the hands. A case involving a young man suffering from several knuckle pad lesions concomitant with pachydermodactyly was studied. This association has not been previously described in the literature. Although it has been reported that both conditions are different manifestations of the same disease, they are believed to be distinct disorders. The compulsive act of rubbing the skin seems to be a common denominator mostly accepted as the cause of both diseases. The authors affirm that knuckle pads may be acquired as an epidermal response, while pachydermodactyly, is a dermal response to the same traumatic factor to the skin. The patient was treated with intralesional infiltration of triamcinolone resulting in a remarkable clinical improvement in both manifestations