Images in Clinical Rheumatology
Pachydermodactyly: The great mimicker
Paquidermodactilia: la gran simuladora
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He reported no pain, limitation or other associated skin or systemic manifestations.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Analysis, which included complete blood count, biochemistry, coagulation, erythrocyte sedimentation rate, C reactive protein, HLA-B27, rheumatoid factor and antinuclear antibodies, was normal or negative. Plain X-ray showed an increase in soft tissue on the second, third and fourth IPJ of the right hand, with no signs of associated joint or bone involvement (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). Magnetic resonance imaging showed oedema and increased soft tissue on the second, third and fourth fingers of the right hand. There were no signs of synovitis or associated collections (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>). A skin biopsy was performed that revealed compact hyperkeratosis and thickening of the dermis, with an increase in the number of collagen fibres and fibroblasts.</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">This led to a diagnosis of classical pachydermodactyly; given the benign nature of this entity and the absence of associated clinical symptoms a wait-and-see approach was decided. After 18 months of six-monthly follow-up in the paediatric dermatology and rheumatology clinic, the patient remains asymptomatic, without pain, functional limitation or other associated clinical manifestations.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Discussion</span><p id="par0020" class="elsevierStylePara elsevierViewall">Paquidermodactyly, initially described in 1973<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a> and later in 1975,<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">2</span></a> is an acquired and under-diagnosed form of digital fibromatosis, of benign course and predominantly affects young males. It is characterised by the presence of progressive, asymptomatic and bilateral swelling of the IP joints of both hands.<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">1–3</span></a> The cause is unknown, although the possible implication of repeated micro trauma, genetic and hormonal factors has been postulated.<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">4,5</span></a> Diagnosis of this entity is essentially clinical, and must be differentiated from juvenile idiopathic arthritis, with characteristic clinical, analytical and radiological findings.<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">4–6</span></a> Clinical treatment measures are preferred, although intralesional glucocorticoids could be used, and surgery as an alternative in some subgroups of patients.<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">3–6</span></a></p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Ethical responsibilities</span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Protection of people and animals</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors declare that neither human nor animal testing has been carried out under this research.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Data confidentiality</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors declare that they have complied with their work centre protocols for the publication of patient data.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Right to privacy and informed consent</span><p id="par0035" class="elsevierStylePara elsevierViewall">The authors have obtained the informed consent of the patients and/or subjects referred to in the article. This document is held by the corresponding author.</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conflict of interests</span><p id="par0040" class="elsevierStylePara elsevierViewall">The authors have no conflict of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:5 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Clinical case" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Discussion" ] 2 => array:3 [ "identificador" => "sec0015" "titulo" => "Ethical responsibilities" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0020" "titulo" => "Protection of people and animals" ] 1 => array:2 [ "identificador" => "sec0025" "titulo" => "Data confidentiality" ] 2 => array:2 [ "identificador" => "sec0030" "titulo" => "Right to privacy and informed consent" ] ] ] 3 => array:2 [ "identificador" => "sec0035" "titulo" => "Conflict of interests" ] 4 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2017-04-01" "fechaAceptado" => "2017-07-13" "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Agudo-Mena JL, Buedo-Rubio MI, García-Atienza EM, Escario-Travesedo E. Paquidermodactilia: la gran simuladora. Reumatol Clin. 2019;15:e156–e157.</p>" ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1035 "Ancho" => 2500 "Tamanyo" => 121914 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A, B) Deformity and swelling on the lateral face of the IPJ of the second, third and fourth fingers, with predominance on the right hand (arrows).</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1095 "Ancho" => 1333 "Tamanyo" => 99500 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Radiographic image with increase in soft tissues on the second, third, and fourth IPJ of the right hand, with no signs of associated joint or bone involvement (arrows).</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1328 "Ancho" => 1333 "Tamanyo" => 126999 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">MRI of right hand, showing an increase in soft tissue with altered signal due to oedema of the second, third and fourth fingers (arrows).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:6 [ 0 => array:3 [ "identificador" => "bib0035" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pachydermie digitale des premières phalanges par hyperplasie conjonctive dermique et aplasie hypodermique" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A. Bazex" 1 => "A. Dupre" 2 => "J. Teillard" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Bull Soc Fr Dermatol Syphiligr" "fecha" => "1973" "volumen" => "80" "paginaInicial" => "455" "paginaFinal" => "458" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0040" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Letter: Pachydermodactyly. A variant of the true knuckle pad" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "J. Verbov" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/archderm.1975.01630160114018" "Revista" => array:5 [ "tituloSerie" => "Arch Dermatol" "fecha" => "1975" "volumen" => "111" "paginaInicial" => "524" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1122155" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0045" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Paquidermodactilia tratada con éxito con infiltraciones de triamcinolona" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A. Plana" 1 => "J. Bassas" 2 => "M.A. Toro" 3 => "C. Ferrandiz" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.adengl.2013.04.024" "Revista" => array:6 [ "tituloSerie" => "Actas Dermosifiliogr" "fecha" => "2014" "volumen" => "105" "paginaInicial" => "319" "paginaFinal" => "321" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24657023" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0050" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A case of pachydermodactyly" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S.H. Seo" 1 => "H.W. Sung" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.5021/ad.2011.23.2.258" "Revista" => array:6 [ "tituloSerie" => "Ann Dermatol" "fecha" => "2011" "volumen" => "23" "paginaInicial" => "258" "paginaFinal" => "261" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21747635" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0055" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Paquidermodactilia en un paciente con trastorno de ansiedad generalizada asociado a tics" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "R. Carrascosa" 1 => "A. Godoy" 2 => "C. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 3 | 4 | 7 |
| 2024 October | 110 | 43 | 153 |
| 2024 September | 143 | 36 | 179 |
| 2024 August | 114 | 42 | 156 |
| 2024 July | 104 | 35 | 139 |
| 2024 June | 84 | 36 | 120 |
| 2024 May | 83 | 40 | 123 |
| 2024 April | 185 | 42 | 227 |
| 2024 March | 160 | 34 | 194 |
| 2024 February | 155 | 41 | 196 |
| 2024 January | 122 | 36 | 158 |
| 2023 December | 164 | 19 | 183 |
| 2023 November | 101 | 30 | 131 |
| 2023 October | 119 | 23 | 142 |
| 2023 September | 119 | 32 | 151 |
| 2023 August | 93 | 14 | 107 |
| 2023 July | 71 | 23 | 94 |
| 2023 June | 90 | 29 | 119 |
| 2023 May | 97 | 24 | 121 |
| 2023 April | 86 | 9 | 95 |
| 2023 March | 156 | 25 | 181 |
| 2023 February | 150 | 31 | 181 |
| 2023 January | 164 | 22 | 186 |
| 2022 December | 124 | 23 | 147 |
| 2022 November | 127 | 31 | 158 |
| 2022 October | 137 | 33 | 170 |
| 2022 September | 173 | 17 | 190 |
| 2022 August | 142 | 42 | 184 |
| 2022 July | 134 | 43 | 177 |
| 2022 June | 163 | 25 | 188 |
| 2022 May | 157 | 47 | 204 |
| 2022 April | 135 | 35 | 170 |
| 2022 March | 121 | 39 | 160 |
| 2022 February | 149 | 43 | 192 |
| 2022 January | 197 | 48 | 245 |
| 2021 December | 95 | 51 | 146 |
| 2021 November | 98 | 43 | 141 |
| 2021 October | 88 | 54 | 142 |
| 2021 September | 93 | 42 | 135 |
| 2021 August | 91 | 59 | 150 |
| 2021 July | 78 | 36 | 114 |
| 2021 June | 69 | 38 | 107 |
| 2021 May | 88 | 42 | 130 |
| 2021 April | 173 | 134 | 307 |
| 2021 March | 90 | 36 | 126 |
| 2021 February | 65 | 27 | 92 |
| 2021 January | 80 | 27 | 107 |
| 2020 December | 47 | 17 | 64 |
| 2020 November | 46 | 13 | 59 |
| 2020 October | 38 | 13 | 51 |
| 2020 September | 37 | 15 | 52 |
| 2020 August | 30 | 19 | 49 |
| 2020 July | 19 | 19 | 38 |
| 2020 June | 10 | 5 | 15 |
| 2020 May | 22 | 19 | 41 |
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