Pachydermodactyly

A 15-year-old boy presented with swelling in his fingers, which had developed over 3 years. He had no history of trauma, pain and fever or morning stiffness. He was right-handed, with anxiety issues and also had repetitive finger friction behaviour. On examination, soft tissue swelling and skin thickening were observed in the lateral of the bilateral second to fourth proximal interphalangeal (PIP) joints bilaterally and left-hand second distal interphalangeal joints (figure 1). Complete blood counts, biochemistry and inflammatory marker levels were normal. Antinuclear antibody, rheumatoid factor and cyclic citrullinated peptide antibodies were negative. The radiograph and MRI scan showed swelling of the soft tissue in the same distribution; there were no abnormalities in the bones or joints. Histological examination revealed hyperkeratosis, hypergranulosis and acanthosis in the epidermis with thick coarse collagen deposits. Mucin deposition was noted in the dermis (figure 2A,B). Pachydermodactyly is a rare...
Source: Archives of Disease in Childhood - Category: Pediatrics Authors: Tags: Miscellanea Source Type: research