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Hlaing SS, Field AY, Mowatt LL, Yee HL, Noguera CM, Palmer GL, Mattis AC, Nelson CC, Fleming JC. Pachydermoperiostosis with bilateral ptosis and its associated systemic comorbidities: a rare case report. Pan Afr Med J 2023; 45:88. [PMID: 37663630 PMCID: PMC10474806 DOI: 10.11604/pamj.2023.45.88.38964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 05/20/2023] [Indexed: 09/05/2023] Open
Abstract
Pachydermoperiostosis is a rare genetic disease known as primary or idiopathic hypertrophic osteoarthropathy (HOA)/Touraine-Solente-Gole syndrome. It is an autosomal dominant or recessive disorder comprising digital clubbing, periostosis, hyperhidrosis, and pachydermia (thickening of facial skin). Ocular manifestations are uncommon; however, blepharoptosis may occur. This case presented with severe bilateral ptosis due to the disease progression. A large 20 mm upper lid resection with levator advancement was performed to improve his ability to see. This is the first reported case of pachydermoperiostosis (PDP) in Jamaica. We present a rare case of pachydermoperiostosis with severe blepharoptosis, who attained a good result with surgical intervention.
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Affiliation(s)
- Su Su Hlaing
- Ophthalmology Division, Kingston Public Hospital, Kingston, Jamaica
| | - Adeola Yvonne Field
- Ophthalmology Division, Faculty of Medical Sciences, University of the West Indies, Kingston, Jamaica
- University Hospital of the West Indies, Kingston, Jamaica
| | - Lizette Lillene Mowatt
- Ophthalmology Division, Faculty of Medical Sciences, University of the West Indies, Kingston, Jamaica
- University Hospital of the West Indies, Kingston, Jamaica
| | - Hsu Lei Yee
- University Hospital of the West Indies, Kingston, Jamaica
| | - Cynthia Marie Noguera
- University of Tennessee Health Sciences Center, Memphis, Tennesse, United States of America
| | | | | | - Christine Carol Nelson
- Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan, United States of America
| | - James Christian Fleming
- Hamilton Eye Institute, University of Tennessee, Memphis, Tennesse, United States of America
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2
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Komatsu-Fujii T, de Jesus CS, Nomura T, Kabashima K. Non-invasive visualization of epidermal hypertrophy of pachydermoperiostosis. J Eur Acad Dermatol Venereol 2023; 37:e344-e345. [PMID: 36226402 DOI: 10.1111/jdv.18654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 10/06/2022] [Indexed: 11/28/2022]
Affiliation(s)
| | | | - Takashi Nomura
- Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan.,Department of Drug Discovery for Intractable Diseases, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kenji Kabashima
- Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan.,Singapore Immunology Network (SIgN) and Institute of Medical Biology, Agency for Science, Technology, and Research (A*STAR), Singapore, Singapore
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3
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Feng Y, Wang A, Dong X, Li C, Yuan K, Huang G, Wei S. Coincidence of pachydermoperiostosis and synovitis, acne, pustulosis, hyperostosis, osteitis syndrome, a causal or casual association? Int J Rheum Dis 2022; 25:1328-1332. [PMID: 35938529 DOI: 10.1111/1756-185x.14418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 07/15/2022] [Accepted: 07/28/2022] [Indexed: 11/30/2022]
Abstract
Pachydermoperiostosis (PDP) is a rare disorder characterized by skin thickening, acropachia, and periostosis. Synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) syndrome is also an orphan disease featured by different dermatological and osteoarthritic manifestations. Herein, we report the first case of an adolescent male diagnosed with both PDP and SAPHO syndrome, presenting with digital clubbing, polyarthralgia, ostealgia, pachydermia and acne on his face, chest and back. Furthermore, we distinguish the characteristics of both diseases and explore the potential pathological mechanism for this coexistence in one patient. Further investigations are needed to establish the detailed pathophysiological association of these 2 diseases.
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Affiliation(s)
- Yuyin Feng
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, China
| | - Afang Wang
- Department of Rheumatology, Fangshan Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Xia Dong
- Department of Rheumatology, Fangshan Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Chen Li
- Department of Rheumatology, Fangshan Hospital, Beijing University of Chinese Medicine, Beijing, China.,Department of Traditional Chinese Medicine, Peking Union Medical College Hospital, Peking Union, Beijing, China
| | - Kai Yuan
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, China
| | - Guangrui Huang
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, China
| | - Shufeng Wei
- Department of Rheumatology, Fangshan Hospital, Beijing University of Chinese Medicine, Beijing, China
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4
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Primary hypertrophic osteoarthropathy - a rare cause of pain and arthritis in children. Description of 5 cases. Cent Eur J Immunol 2022; 47:280-287. [PMID: 36817261 PMCID: PMC9896987 DOI: 10.5114/ceji.2022.120171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 07/13/2022] [Indexed: 11/17/2022] Open
Abstract
Primary hypertrophic osteoarthropathy (PHOA) is a very rare disease. The typical triad of symptoms, i.e. digital clubbing, periosteal bone formation with bone and joint deformities and skin hypertrophy, may be accompanied by other specific conditions. In the majority of patients, the picture of the disease is incomplete. The dominant clinical symptom may be osteoarticular complaints. Moreover, the final confirmation of the diagnosis of the primary form of hypertrophic osteoarthropathy requires the analysis of much more frequent secondary causes of the disease. Diagnosing primary osteoarthropathy in children is particularly difficult. Some children report joint pain before the onset of the other symptoms of osteoarthropathy, while the physical and imaging examinations show features of arthritis. This can lead to misdiagnoses including the diagnosis of juvenile idiopathic arthritis (JIA) and the unnecessary use of immunosuppressive treatment. The present description of five patients from the Paediatric Rheumatology Department indicates diagnostic difficulties in children with PHOA. All of them were examined due to pain and features of arthritis. We observed an incomplete clinical picture of the disease. One patient required a revision of the previous diagnosis of JIA and discontinuation of ineffective treatment with disease-modifying antirheumatic drugs (DMARDs). PHOA should always be considered in the differential diagnosis of arthritis in children, due to the slow and often atypical development of symptoms, including the presence of pain and arthritis as the predominant symptom of the disease.
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5
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Swamynathan S, Srinivas S, Nagarajappa V, Palany R. Complete form of pachydermoperiostosis in a 16-year-old boy: A case report. INDIAN JOURNAL OF PAEDIATRIC DERMATOLOGY 2022. [DOI: 10.4103/ijpd.ijpd_77_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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6
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Khalil G, Nawfal G, Mikhael E, Hage K. Whole body diffusion weighted imaging with background suppression in pachydermoperiostosis: a case report. Clin Imaging 2022; 84:38-42. [DOI: 10.1016/j.clinimag.2021.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 11/20/2021] [Accepted: 12/09/2021] [Indexed: 11/03/2022]
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7
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Taneja N, Gunaabalaji DR, Gupta S. Rhytidectomy for pachydermoperiostosis. Indian J Dermatol Venereol Leprol 2021; 87:863-864. [PMID: 34623052 DOI: 10.25259/ijdvl_1001_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 05/01/2021] [Indexed: 11/04/2022]
Affiliation(s)
- Neha Taneja
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - D R Gunaabalaji
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Somesh Gupta
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
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Vanhoenacker FM, Simoni P, Bosmans F, Boutry N. Congenital and Developmental Abnormalities of the Hand and Wrist. Semin Musculoskelet Radiol 2021; 25:260-271. [PMID: 34082451 DOI: 10.1055/s-0040-1722613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Identification of congenital skeletal abnormalities is complex because of the large variety of individual syndromes and dysplasias that are often difficult to remember. Although a correct diagnosis relies on a combination of clinical, radiologic, and genetic tests, imaging plays an important role in selecting those patients who should be referred for further genetic counseling and expensive genetic tests. In addition to information derived from radiologic analysis of other skeletal elements, radiographs of the hand and wrist may provide particular useful information. In the first part of this article, we provide a guide for a systematic radiologic analysis of the hand and wrist bones that may help characterize congenital and developmental diseases. Special attention is given to the use of correct terminology. In the second part, we discuss typical examples of congenital and developmental diseases involving the hand and wrist, with an emphasis on skeletal dysplasias.
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Affiliation(s)
- Filip M Vanhoenacker
- Department of Radiology, Antwerp University Hospital/University of Antwerp, Edegem, Belgium.,Department of Radiology, AZ Sint-Maarten, Mechelen, Belgium.,Department of Radiology, Ghent University Hospital/University of Ghent, Ghent, Belgium
| | - Paolo Simoni
- Department of Pediatric Radiology and Medical Imaging, Hôpital Universitaire Des Enfants Reine Fabiola (HUDERF), Université Libre de Bruxelles, Bruxelles, Belgium
| | - Frederik Bosmans
- Department of Radiology, Antwerp University Hospital/University of Antwerp, Edegem, Belgium.,Department of Radiology, AZ Sint-Maarten, Mechelen, Belgium
| | - Nathalie Boutry
- Department of Pediatric Radiology, Jeanne de Flandre Hospital, CHU Lille, France
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9
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Kharbanda R, Sundaram TG, Gupta L. Pachydermoperiostosis: Classic Presentation of a Rare Disease. Mediterr J Rheumatol 2020; 31:214-215. [PMID: 32676559 PMCID: PMC7362114 DOI: 10.31138/mjr.31.2.214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 06/10/2020] [Accepted: 06/19/2020] [Indexed: 11/18/2022] Open
Affiliation(s)
- Rajat Kharbanda
- Department of Clinical Immunology & Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - T G Sundaram
- Department of Clinical Immunology & Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Latika Gupta
- Department of Clinical Immunology & Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
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10
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Prasad A, Shahi P, Sehgal A, Bhagirathi Mallikarjunaswamy M. Incomplete primary hypertrophic osteoarthropathy. BMJ Case Rep 2020; 13:13/5/e236034. [PMID: 32404375 DOI: 10.1136/bcr-2020-236034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Avijeet Prasad
- Department of Orthopaedics, University College of Medical Sciences, New Delhi, Delhi, India
| | - Pratyush Shahi
- Department of Orthopaedics, University College of Medical Sciences, New Delhi, Delhi, India
| | - Apoorv Sehgal
- Department of Orthopaedics, University College of Medical Sciences, New Delhi, Delhi, India
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11
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Akaranuchat N, Limsuvan P. Touraine-Solente-Gole syndrome: Clinical manifestation with bilateral true eyelid ptosis. JPRAS Open 2020; 21:6-13. [PMID: 32158879 PMCID: PMC7061552 DOI: 10.1016/j.jpra.2019.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 04/16/2019] [Indexed: 11/03/2022] Open
Abstract
Touraine-Solente-Gole syndrome (pachydermoperiostosis [PDP] or primary idiopathic hypertrophic osteoarthropathy [HOA]) is a rare hereditary disorder that is characterized by a triad of manifestations that consists of skin changes (pachydermia), abnormal bone and joint manifestations (periostosis and/or artritis), and digital clubbing (acropachia). Here, we report the case of 24-year-old male who presented with severe bilateral true eyelid ptosis. Physical examination revealed severe ptosis with poor function of the levator palpabrae superioris muscle, thickening of and deep grooves in facial skin (especially at the frontal region), and abnormal appearance of the scalp with accentuating folds and deep furrows (cutis verticis gyrata). Abnormal bone enlargement of the hands, knees, and feet was also observed. Frontal rhytidectomy and levator resection and advancement were performed to alleviate symptoms. At the short-term follow-up, the patient described being satisfied with the outcome of treatment. This patient will be routinely followed over the long term to evaluate disease progression. Although the cause of ptosis in most PDP is mechanical process or dysfunction, this case of PDP had bilateral true eyelid ptosis due to poor levator palpabrae superioris muscle excursion with coexisting signs and symptoms of complete form PDP. This finding highlights the need to investigate for bilateral true eyelid ptosis caused by abnormal levator palpabrae superioris muscle function in patients diagnosed with PDP.
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Affiliation(s)
- Nutthawut Akaranuchat
- Division of Plastic Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok 10700, Thailand
| | - Papassorn Limsuvan
- Division of Plastic Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok 10700, Thailand
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12
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Salah BI, Husari KI, Hassouneh A, Al‐Ali Z, Rawashdeh B. Complete primary pachydermoperiostosis: A case report from Jordan and review of literature. Clin Case Rep 2019; 7:346-352. [PMID: 30847204 PMCID: PMC6389490 DOI: 10.1002/ccr3.1971] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Revised: 11/02/2018] [Accepted: 11/16/2018] [Indexed: 12/05/2022] Open
Abstract
Complete Primary Pachydermoperiostosis is a rare syndrome that presents with skin and skeletal manifestations. Though diagnosis can be made on the basis of the classic clinical and radiological features, it is often missed due to variable presentations. Therefore, it is important to know about this syndrome to reach correct diagnosis.
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Affiliation(s)
- Bareqa I. Salah
- General Surgery DepartmentJordan University HospitalAmmanJordan
| | - Khalil I. Husari
- Maxillofacial Surgery DepartmentJordan University HospitalAmmanJordan
| | - Ala’ Hassouneh
- General Surgery DepartmentJordan University HospitalAmmanJordan
| | - Zaid Al‐Ali
- Maxillofacial Surgery DepartmentJordan University HospitalAmmanJordan
| | - Baeth Rawashdeh
- Special Surgery DepartmentJordan University HospitalAmmanJordan
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13
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Abstract
Touraine-Solente-Gole syndrome, also known as Pachydermoperiostosis (PDP) or Primary Hypertrophic Osteoarthropathy, is a rare hereditary disorder, which affects both bones and skin. It is characterized by a combination of dermatologic changes (pachydermia or thickening of the skin) and rheumatologic manifestations (periostosis and finger clubbing). Eyelid ptosis which is caused by thickened eyelids (blepharoptosis) is a less common symptom. We report the case of a patient with a complete form of Touraine-Solente-Gole syndrome with bilateral blepharoptosis as presenting feature.
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Affiliation(s)
- Dharmil Doshi
- a Department of Ophthalmology, Nagri Eye Research Foundation & C H Nagri Eye Hospital , Ahmedabad , India
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14
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Pachydermoperiostosis in a Patient with Crohn's Disease: Treatment and Literature Review. IRANIAN JOURNAL OF MEDICAL SCIENCES 2018; 43:81-85. [PMID: 29398756 PMCID: PMC5775998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Pachydermoperiostosis (PDP) is a rare disorder characterized by pachydermia, digital clubbing, periostitis, and an excess of affected males. It is the primary form of hypertrophic osteoarthropathy (HOA) and there are some rare associations of PDP with other disorders. Here we describe a patient with Crohn's disease associated with PDP. A 26-year-old man, who was a known case of Crohn's disease, referred with diffuse swelling in the upper and lower limbs and cutis verticis gyrata since 7 years ago. PDP was suspected and endocrinological and radiological studies were conducted for the evaluation of underlying disease. He was prescribed celecoxib, low-dose prednisolone, and pamidronate to control the swelling, periostitis, azathiopurine, and mesalazine according to gastrointestinal involvement. In conclusion, it is important to identify this condition since a misdiagnosis might subject the patient to unnecessary investigations.
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15
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Lebas E, Chian C, Nikkels-Tassoudji N, Arrese JE, Nikkels AF. Pachyderma in Primary Cutaneous NK and T-Cell Lymphoma and Leukemia Cutis. Case Rep Dermatol 2017; 9:151-157. [PMID: 29033820 PMCID: PMC5637003 DOI: 10.1159/000480068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 08/02/2017] [Indexed: 11/19/2022] Open
Abstract
Background Pachyderma is defined as severely thickened skin with deep folds and is occasionally observed with primary cutaneous NK and T-cell lymphoma (pCNKTCL), primary cutaneous B-cell lymphoma (pCBCL), and leukemia cutis (LC). Aim To describe the clinical, histological, and therapeutic particularities of a series of pCNKTCL, pCBCL, and LC patients with pachyderma. Results In a series of pCNKTCL (n = 70), pCBCL (n = 12), and LC (n = 2) patients followed up during 9 years, 6 cases of pachyderma were observed. Pachyderma occurred on the arms (n = 2), thighs (n = 1), forehead (n = 1), and face (n = 2). The mean age of the patients was 69 years (51–82). The stages were erythrodermic (T4) mycosis fungoides (MF) (n = 1), folliculotropic MF (FMF) (n = 2), classic (T2) MF (n = 2), and chronic myeloid leukemia (n = 1). The erythrodermic MF patient with acute pachyderma on the right arm responded rapidly to oral steroids. The other cases were indolent, appeared progressively, and were highly treatment resistant. Histology revealed dense dermal neoplastic infiltration. The immunohistological profile of the pachydermic lesions was similar to common MF and LC. Conclusion Pachyderma is an atypical manifestation of MF and LC and may occur on the face (FMF) or the extremities (MF). The rapidly appearing pachyderma may be transitory and responds readily to oral steroids.
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Affiliation(s)
- Eve Lebas
- Department of Dermatology, Liège University Hospital, Liège, Belgium
| | - Cesar Chian
- Department of Pathology, Hospital Arzobispo Loayza, Lima, Peru
| | | | - Jorge E Arrese
- Department of Dermatopathology, Liège University Hospital, Liège, Belgium
| | - Arjen F Nikkels
- Department of Dermatology, Liège University Hospital, Liège, Belgium
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Wen X, Li Y, Hamblin MR, Jiang X. Facial Manifestations of Pachydermoperiostosis Treated with Botulinum Toxin Type-A: Report of 3 Cases. Acta Derm Venereol 2017; 97:761-762. [PMID: 28224169 PMCID: PMC5475399 DOI: 10.2340/00015555-2645] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Affiliation(s)
- Xiang Wen
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
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17
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Dogan AS, Acaroglu G, Dikmetas O. Blepharoptosis and hypertrophic osteoarthropathy: A case report. Indian J Ophthalmol 2016; 64:317-9. [PMID: 27221686 PMCID: PMC4901852 DOI: 10.4103/0301-4738.182948] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
A 52-year-old male patient presented to our hospital with a history of secondary hypertrophic osteoarthropathy (HOA) associated with an abdominal neoplasia and blepharoptosis. He had finger clubbing, hyperhidrosis, and hypertrichosis. He also had a recent history of extensive abdominal surgery with a pathology report of myelolipoma. Routine blood work was unremarkable. Upper eyelid reconstruction with blepharoplasty, upper eyelid wedge resection, and brow suspension was performed to address his eyelid concerns. By this case report, we would like to attract notice that the eyelid involvement may be a part of HOA and to emphasize the importance of systemic and pathologic evaluation in failed blepharoptosis surgery.
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Affiliation(s)
- Aysun Sanal Dogan
- Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Gölge Acaroglu
- Private Practicer, İran Caddesi 45/2 06700 Kavaklıdere, Ankara, Turkey
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