Rheumatology International

, Volume 32, Issue 6, pp 1747–1750 | Cite as

Unusual unilateral presentation of pachydermodactyly: a case report

  • Hasan UlusoyEmail author
  • Nevsun Pihtili Tas
  • Gurkan Akgol
  • Arif Gulkesen
  • Ayhan Kamanli
Original Article


Pachydermodactyly is a rare digital fibromatosis characterized by asymptomatic fusiform soft-tissue swellings of the proximal interphalangeal joints of the hands. It usually affects healthy adolescent males with a negative family history. As a rule, clinical presentation of the disease is bilateral and symmetrical enlargement of the joints. So it can be misdiagnosed with inflammatory rheumatic diseases, especially with juvenile chronic arthritis. A prompt clinical diagnosis of the disease would prevent inappropriate treatment with immunosuppressive agents or steroids and unnecessary expensive diagnostic procedures such as biopsy or magnetic resonance imaging. Once diagnosed, patients should be advised in order to avoid repetitive traumas of the hands, rubbing and cracking of the fingers, obsessive–compulsive use of computer and video games. The joint outcome is always benign. Here, we report a case of pachydermodactyly differs from the typical clinical picture of pachydermodactyly in the unilateral distribution of the lesions.


Pachydermodactyly Digital fibromatosis Painless joint swelling Obsessive compulsive disorder 


  1. 1.
    Basex A, Dupre A, Teillard J (1973) Pachydermie digitale des premie`res phalanges par hyperplasie conjonctive dermique et aplasie hypodermique. Bull Soc Fr Dermatol Syphiligr 80:455–458Google Scholar
  2. 2.
    Verbov J (1975) Pachydermodactyly: a variant of the true knuckle pad. Arch Dermatol 111:524PubMedCrossRefGoogle Scholar
  3. 3.
    Beltraminelli H, Itin P (2009) Pachydermodactyly–just a sign of emotional distress. Eur J Dermatol 19:5–13PubMedGoogle Scholar
  4. 4.
    Martin JC, Rennie JAN, Kerr KM (1992) Pachydermodactyly: confused with JCA. Ann Rheum Dis 51:1101–1102PubMedGoogle Scholar
  5. 5.
    Shuang Y, Shun-Le C, Yu-Qi D, Fen L, Qiang G, Chun-De B (2005) Pachydermodactyly: six new cases from China. J Clin Rheumatol 11:72–75CrossRefGoogle Scholar
  6. 6.
    Anandacoomarasami A, Bak AS, Peduto A (2005) Magnetic resonace imaging in pachydermodactyly. J Rheumatol 32:2239–2241Google Scholar
  7. 7.
    Sandobal C, Kuznietz A, Varizat A, Roverano S, Paira S (2007) Pachydermodactyly: four additional cases. Clin Rheumatol 26:962–964PubMedCrossRefGoogle Scholar
  8. 8.
    Taylor-Gjevre R, Saxena A, El Maadawy S, Classen D, Nair B, Gjevre J (2009) A case of deforming pachydermodactyly. J Clin Rheumatol 15:78–80PubMedCrossRefGoogle Scholar
  9. 9.
    Itin PH, Lautenschlager S (1995) Pachydermodactyly: a psychocutaneous disorder. Dermatology 190:1–3PubMedCrossRefGoogle Scholar
  10. 10.
    Cabanillas M, Monteagudo B, Leon-Muinos E, Suarez-Amor O (2010) Pachydermodactyly in a young girl: cutaneous manifestation of a psychiatric disorder? Pediatr Dermatol 27:306–308PubMedCrossRefGoogle Scholar
  11. 11.
    Veraldi S, Rizzitelli G, Brusasco A (1996) Pachydermodactyly of a single finger. Eur J Dermatol 6:576–578Google Scholar
  12. 12.
    Saka B, Mezdegi A, Ozturk A, Erten N, Cefle K, Palanduz S (2005) Two siblings with distal pachydermodactly. Clin Exp Dermatol 30:707–709PubMedCrossRefGoogle Scholar
  13. 13.
    Tompkins SD, McNutt NS, Shea CR (1998) Distal pachydermodactyly. J Am Acad Dermatol 38:359–362PubMedCrossRefGoogle Scholar
  14. 14.
    Reichert CM, Costa J, Barsky SH, Claysmith AP, Liotta LA, Enzinger FM et al (1985) Pachydermodactyly. Clin Orthop Relat Res 194:252–257PubMedGoogle Scholar
  15. 15.
    Lo WL, Wong CK (1993) Localized pachydermodactily in tuberous sclerosis. Clin Exp Dermatol 18:146–147PubMedCrossRefGoogle Scholar
  16. 16.
    Bardazzi F, Neri I, Fanti PA, Patrizi A (1996) Pachydermodactyly in two young girls. Pediatr Dermatol 13:288–291PubMedCrossRefGoogle Scholar
  17. 17.
    Callot V, Wechsler J, Hovnanian A, Revuz J (1996) Pachydermodactyly and atrophia maculosa varioliformis cutis. Dermatology 190:56–58CrossRefGoogle Scholar
  18. 18.
    Woodrow SL, Burrow NO (2003) Pachydermodactyly in association with Asperger syndrome. Clin Exp Dermatol 28:674–675PubMedCrossRefGoogle Scholar
  19. 19.
    Ehl S, Uhl M, Berner R, Bonafe L, Superti-Furga A, Kirchhoff A (2004) Clinical, radiographic, and genetic diagnosis of progressive pseudorheumatoid dysplasia in a patient with severe polyarthropathy. Rheumatol Int 24:53–56PubMedCrossRefGoogle Scholar
  20. 20.
    Kaya A, Ozgocmen S, Kiris A (2005) Ciftci I (2005) Clinical and radiological diagnosis of progressive pseudorheumatoid dysplasia in two sisters with severe polyarthropathy. Clin Rheumatol 24:560–564PubMedCrossRefGoogle Scholar
  21. 21.
    Sinha GP, Curtis P, Haigh D, Lealman GT, Dodds W, Bennett CP (1997) Pachydermoperiostosis in childhood. Br J Rheumatol 36:1224–1227PubMedCrossRefGoogle Scholar
  22. 22.
    Guberman D, Lichtenstein DA, Vardy DA (1996) Knuckle pads—a forgotten skin condition: report of a case and review of the literature. Cutis 57:241–242PubMedGoogle Scholar
  23. 23.
    Calikoglu E (2003) Pseudo-knuckle pads: an unusual cutaneous sign of obsessive-compulsive disorder in adolescent patient. Turk J Pediatr 45:348–349PubMedGoogle Scholar
  24. 24.
    Wollina U (2005) Chewing pads versus pachydermodactily: comment on the clinical image by Akikusa et al. Arthritis Rheum 52:2953PubMedCrossRefGoogle Scholar
  25. 25.
    Mangat P, Jawad AS (2005) Case number 32: Thiemann’s disease. Ann Rheum Dis 64:11–12PubMedCrossRefGoogle Scholar
  26. 26.
    Meunier L, Pailler C, Barneon G, Meynadier J (1994) Pachydermodactyly or acquired digital fibromatosis. Br J Dermatol 131:744–746PubMedCrossRefGoogle Scholar
  27. 27.
    Aoki K, Iida H, Umeda T (1994) A case of pachydermodactyly. Jpn J Plast Reconstr Surg 37:109–113Google Scholar
  28. 28.
    Lautenschlager S, Itin PH, Rufli T (1994) Pachydermodactyly: reflecting obsessive-compulsive behavior? Arch Dermatol 130:387PubMedCrossRefGoogle Scholar
  29. 29.
    Iraci S, Bianchi L, Innocenzi D et al (1993) Pachydermodactyly: a case of an unusual type of reactive digital fibromatosis. Arch Dermatol 129:247–248PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Hasan Ulusoy
    • 1
    Email author
  • Nevsun Pihtili Tas
    • 1
  • Gurkan Akgol
    • 1
  • Arif Gulkesen
    • 1
  • Ayhan Kamanli
    • 1
  1. 1.Division of Rheumatology, Department of Physical Medicine and RehabilitationFirat University, Faculty of MedicineElazigTurkey

Personalised recommendations