Pachydermodactyly - A Case Report and Review of Literature

Abstract

Introduction: Pachydermodactyly is an uncommon or under diagnosed variant of digital fibromatosis. It is a benign disease, described by symmetric proximal interphalangeal (PIP) involvement, progressive swelling, absence of inflammation or pain, and without limitation of function. It has been linked in some cases with psychiatric disorders such as obsessive-compulsive disorder or repetitive mechanical stimulation.

Case report: We aim to report a case of pachydermodactyly that was diagnosed in a young 17-year-old male patient with painless swelling of the digits mainly at PIP joints with hyperkeratosis that was treated conservatively.

Conclusion: Pachydermodactyly is an under diagnosed and underestimated entity; the recognition of a case in clinical practice can prove to be challenging. A high index of suspicion must be kept at all times when no reason for the swelling is found.

Keywords: Digits; joint swelling; pachydermodactyly; proximal interphalangeal.

Figure 1

(a and b) Clinical picture showing swollen proximal interphalangeal joints.

Figure 2

(a and b) X-ray showing swollen proximal interphalangeal joints, normal joint anatomy.

Figure 3

(a and b) Magnetic resonance imaging of the hand showing no inflammation process in the proximal interphalangealjoints.