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Case Reports
. 2016 Feb;95(6):e2762.
doi: 10.1097/MD.0000000000002762.

Using a Distant Abdominal Skin Flap to Treat Digital Constriction Bands: A Case Report for Vohwinkel Syndrome

Mingzi Zhang  1 , Kexin Song, Ning Ding, Chang Shu, Youbin Wang
Affiliations
Case Reports

Using a Distant Abdominal Skin Flap to Treat Digital Constriction Bands: A Case Report for Vohwinkel Syndrome

Mingzi Zhang et al. Medicine (Baltimore). 2016 Feb.

Abstract

In this study, a Vohwinkel syndrome case is presented where in 5th digit constriction bands in the right hand were reconstructed using a distant abdominal skin flap. Vohwinkel syndrome, or keratoderma hereditarium mutilans, is a rare, autosomal dominant genetic skin condition that causes palmoplantar hyperkeratosis and constricts finger and/or toe bands. In a typical manifestation, the finger and toe constriction bands lead to progressive strangulation and autoamputation, which requires immediate clinical treatment. Topical keratolytics and systemic retinoids have been used to treat hyperkeratosis but without consistent results. Only 1 effective approach for autoamputation has been accepted, reconstructive surgery.Applying a distant abdominal skin flap produced satisfying postoperative effects at the 18-month follow-up.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

FIGURE 1
FIGURE 1
(A) Right palm hyperkeratosis, (B) the constriction band on the 5th finger of the right hand severely congested blood flow to and from the distal portion of the finger.
FIGURE 2
FIGURE 2
Surgical procedures: (A) Bridge-shaped skin flap on the abdomen of 5 × 1 cm was designed according to the constriction length. (B, C) Separated skin flap and sutured bottom incision. (D) The skin flap covered the constriction wound after excision.
FIGURE 3
FIGURE 3
Histopathological examination of the constriction band. The keratin increased significantly.
FIGURE 4
FIGURE 4
(A, B) A 12-month follow-up after surgery. (C, D) An 18-month follow-up after surgery. The constriction band was replaced with an abdominal skin flap, after which no congestion was observed.
See this image and copyright information in PMC

References

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Publication types

Supplementary concepts