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Yamamoto H, Taniguchi Y. Hypertrophic Osteoarthropathy Associated With Pancoast Tumor: Do Not Miss Secondary Hypertrophic Osteoarthropathy! J Clin Rheumatol 2023; 29:e121. [PMID: 37370203 DOI: 10.1097/rhu.0000000000001995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
Affiliation(s)
- Hirotaka Yamamoto
- From the Department of Endocrinology, Metabolism, Nephrology, and Rheumatology, Kochi Medical School Hospital, Kochi University, Nankoku, Kochi, Japan
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2
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Singh D, Rawat R, Thakur V. Pachydermoperiostosis with Hearing Loss. Skinmed 2022; 20:311-313. [PMID: 35976025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
A 21-year-old unmarried man, born of a non-consanguineous marriage, presented to the dermatology department with progressive thickening of the facial skin and eyelids, plus increased folds over his forehead for the last 5 months. He also complained of progressive enlargement of his hands and feet, with intermittent joint pains in his wrists, elbows, and ankles, along with occasional abdominal pain. He had a hearing loss and increased sweating. (SKINmed. 2022;20:311-313).
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Affiliation(s)
- Dilbag Singh
- Department of Dermatology, Venereology and Leprology, Pt. Jawahar Lal Nehru Government Medical College, Chamba, HP, India
| | - Ritu Rawat
- Department of Dermatology, Venereology and Leprology, Pt. Jawahar Lal Nehru Government Medical College, Chamba, HP, India;
| | - Vishal Thakur
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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3
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Tapia N, Sharma S, Koirala M, Blumenthal D. Rosai-Dorfman Disease Occurring in an Elderly Patient With Long-Standing Idiopathic Hypertrophic Osteoarthropathy. J Clin Rheumatol 2021; 27:S713-S714. [PMID: 32897997 DOI: 10.1097/rhu.0000000000001561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Nilson Tapia
- From the Department of Medicine, NYC Health + Hospitals/Woodhull, Brooklyn, NY
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Jiang Y, Du J, Song YW, Wang WB, Pang QQ, Li M, Wang O, Lian XL, Xing XP, Xia WB. Novel SLCO2A1compound heterozygous mutation causing primary hypertrophic osteoarthropathy with Bartter-like hypokalemia in a Chinese family. J Endocrinol Invest 2019; 42:1245-1252. [PMID: 31004291 DOI: 10.1007/s40618-019-01048-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Accepted: 04/08/2019] [Indexed: 11/29/2022]
Abstract
PURPOSE Primary hypertrophic osteoarthropathy (PHO) is an inherited disease characterized by digital clubbing, periostosis and pachydermia with defects in the degradation of prostaglandin E2 (PGE2). Mutations in SLCO2A1 gene-encoding prostaglandin transporter (PGT) resulted in PHO, autosomal recessive 2 (PHOAR2). The spectrum of mutations and variable clinical complications of PHOAR2 has been delineated. In this study, we investigated a Chinese PHO family with a manifestation of Bartter-like hypokalemia. METHODS Clinical manifestations were collected and genetic analyses were performed in the PHO family. RESULTS The 33-year-old male proband had severe hypokalemia due to potassium loss from the kidney, while his brother had mild hypokalemia. After being treated with etoricoxib, the serum potassium level of the patient increased rapidly to the normal range which corresponded with the reduction in his serum PGE2 and PE2 metabolite (PGEM) levels. A novel SLCO2A1 compound heterozygous mutation of p.I284V and p.C459R was identified in two PHO patients in this family. CONCLUSIONS The present findings supported that the Bartter-like hypokalemia is a new complication of PHOAR2 caused by the high level of PGE2. Etoricoxib was demonstrated to be effective for the renal hypokalemia in PHO patients.
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Affiliation(s)
- Y Jiang
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health Commission, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, 100730, China
| | - J Du
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health Commission, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, 100730, China
| | - Y-W Song
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health Commission, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, 100730, China
| | - W-B Wang
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health Commission, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, 100730, China
| | - Q-Q Pang
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health Commission, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, 100730, China
| | - M Li
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health Commission, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, 100730, China
| | - O Wang
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health Commission, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, 100730, China
| | - X-L Lian
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health Commission, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, 100730, China
| | - X-P Xing
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health Commission, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, 100730, China
| | - W-B Xia
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health Commission, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, 100730, China.
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5
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Umeno J, Esaki M, Hirano A, Fuyuno Y, Ohmiya N, Yasukawa S, Hirai F, Kochi S, Kurahara K, Yanai S, Uchida K, Hosomi S, Watanabe K, Hosoe N, Ogata H, Hisamatsu T, Nagayama M, Yamamoto H, Abukawa D, Kakuta F, Onodera K, Matsui T, Hibi T, Yao T, Kitazono T, Matsumoto T. Clinical features of chronic enteropathy associated with SLCO2A1 gene: a new entity clinically distinct from Crohn's disease. J Gastroenterol 2018; 53:907-915. [PMID: 29313109 PMCID: PMC6061663 DOI: 10.1007/s00535-017-1426-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 12/21/2017] [Indexed: 02/04/2023]
Abstract
BACKGROUND Chronic enteropathy associated with SLCO2A1 gene (CEAS) is a hereditary disease caused by mutations in the SLCO2A1 gene and characterized by multiple small intestinal ulcers of nonspecific histology. SLCO2A1 is also a causal gene of primary hypertrophic osteoarthropathy (PHO). However, little is known about the clinical features of CEAS or PHO. METHODS Sixty-five Japanese patients recruited by a nationwide survey of CEAS during 2012-2016 were enrolled in this present study. We reviewed the clinical information of the genetically confirmed CEAS patients. RESULTS We identified recessive SLCO2A1 mutations at 11 sites in 46 patients. Among the 46 patients genetically confirmed as CEAS, 13 were men and 33 were women. The median age at disease onset was 16.5 years, and parental consanguinity was present in 13 patients (28%). Anemia was present in 45 patients (98%), while a single patient experienced gross hematochezia. All patients showed relatively low inflammatory markers in blood tests (median CRP 0.20 mg/dl). The most frequently involved gastrointestinal site was the ileum (98%), although no patient had mucosal injuries in the terminal ileum. Mild digital clubbing or periostosis was found in 13 patients (28%), with five male patients fulfilling the major diagnostic criteria of PHO. CONCLUSIONS The clinical features of CEAS are distinct from those of Crohn's disease. Genetic analysis of the SLCO2A1 gene is therefore recommended in patients clinically suspected of having CEAS.
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Affiliation(s)
- Junji Umeno
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Motohiro Esaki
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Atsushi Hirano
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yuta Fuyuno
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Naoki Ohmiya
- Department of Gastroenterology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Shigeyoshi Yasukawa
- Department of Gastroenterology, Fukuoka University Chikushi Hospital, Chikushino, Japan
| | - Fumihito Hirai
- Department of Gastroenterology, Fukuoka University Chikushi Hospital, Chikushino, Japan
| | - Shuji Kochi
- Department of Gastroenterology, Matsuyama Red Cross Hospital, Matsuyama, Japan
| | - Koichi Kurahara
- Department of Gastroenterology, Matsuyama Red Cross Hospital, Matsuyama, Japan
| | - Shunichi Yanai
- Division of Gastroenterology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Morioka, Japan
| | - Keiichi Uchida
- Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, Tsu, Japan
| | - Shuhei Hosomi
- Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Kenji Watanabe
- Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
- Department of Intestinal Inflammation Research, Hyogo College of Medicine, Nishinomiya, Japan
| | - Naoki Hosoe
- Center for Diagnostic and Therapeutic Endoscopy, Keio University School of Medicine, Tokyo, Japan
| | - Haruhiko Ogata
- Center for Diagnostic and Therapeutic Endoscopy, Keio University School of Medicine, Tokyo, Japan
| | - Tadakazu Hisamatsu
- The Third Department of Internal Medicine, Kyorin University School of Medicine, Mitaka, Japan
| | - Manabu Nagayama
- Division of Gastroenterology, Department of Medicine, Jichi Medical University, Tochigi, Japan
| | - Hironori Yamamoto
- Division of Gastroenterology, Department of Medicine, Jichi Medical University, Tochigi, Japan
| | - Daiki Abukawa
- Department of General Pediatrics, Miyagi Children's Hospital, Sendai, Japan
| | - Fumihiko Kakuta
- Department of General Pediatrics, Miyagi Children's Hospital, Sendai, Japan
| | - Kei Onodera
- Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Toshiyuki Matsui
- Department of Gastroenterology, Fukuoka University Chikushi Hospital, Chikushino, Japan
| | - Toshifumi Hibi
- Center for Advanced IBD Research and Treatment, Kitasato University, Kitasato Institute Hospital, Tokyo, Japan
| | | | - Takanari Kitazono
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takayuki Matsumoto
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
- Division of Gastroenterology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Morioka, Japan.
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Ahmmed MF, Shazzad MN, Ferdous S, Azad AK, Haq SA. Polyarthritis is a Rare Manifestation of Pachydermoperiostosis: A Case Report. Mymensingh Med J 2017; 26:939-943. [PMID: 29208888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Pachydermoperiostosis or primary hypertrophic osteoarthropathy, also known as Touraine-Solente-Gole syndrome, is a rare process, frequently inherited. In its complete form it is characterized by pachydermia (thickening of the skin), skeletal changes (periostosis) and acropachia (digital clubbing). Diagnosis can be made considering the typical clinical features and the histological feature. We report a patient of 25-year old man presented with joint pain involving in multiple joints for last 7 years and progressive enlargement of his hands and feet with profuse sweating of palms and soles for last 4 years. Physical examination revealed thickened skin with excessive furrowing of his forehead, dropping of both eyelids, clubbing of all fingers, toes and enlargement of his hands and feet with pamoplantar hyperhidrosis. Laboratory investigation shows raised CRP, X-ray feet lateral view showed normal heel pad thickness, new bone formation and periosteal elevation in lower end of tibia and fibula and skin biopsy showed dense fibrocollagenous tissue in dermis and subcutis and mild acanthosis. With this scenario he was diagnosed as primary hypertrophic osteoarthropathy (Pachydermoperiostosis). After diagnosis he was treated with cholchicine (0.6mg) twice daily, naproxen (500mg) twice daily, and risedronate (150mg) monthly. After one year his skin texture became less thickened, joint pain improved, there was no further enlargement of acral part of fore arm. In this report we review the characteristic features of this syndrome. We highlight the importance of ruling out secondary forms of hypertrophic osteoarthropathy and of a close follow-up of these patients because of complications that might develop on long-term. Although no treatment was satisfactory, we wanted to emphasize that NSAIDs, Cholchicine and risedronate could be an effective treatment option.
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Affiliation(s)
- M F Ahmmed
- Dr Md Faysal Ahmmed, Resident, Department of Rheumatology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
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7
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Affiliation(s)
- Xiang Wen
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
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8
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de Risi-Pugliese T, Danière F, Legrand L, Bancel P, Oppenheim C, Wipff J. Extramedullary hematopoiesis with spinal cord compression in pachydermoperiostosis. Joint Bone Spine 2016; 84:509-510. [PMID: 27777168 DOI: 10.1016/j.jbspin.2016.08.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 08/31/2016] [Indexed: 11/19/2022]
Affiliation(s)
- Tullia de Risi-Pugliese
- Paris Descartes University, Sorbonne Paris Cité, 75006 Paris, France; Rheumatology A Department, Cochin Hospital, APHP, 75014 Paris, France
| | - Florian Danière
- Paris Descartes University, Sorbonne Paris Cité, 75006 Paris, France; Neuroradiology Department, Sainte-Anne Hospital, 75014 Paris, France
| | - Laurence Legrand
- Paris Descartes University, Sorbonne Paris Cité, 75006 Paris, France; Neuroradiology Department, Sainte-Anne Hospital, 75014 Paris, France
| | - Philippe Bancel
- Paris Descartes University, Sorbonne Paris Cité, 75006 Paris, France; Orthopedic Department, Cochin Hospital, APHP, 75014 Paris, France
| | - Catherine Oppenheim
- Paris Descartes University, Sorbonne Paris Cité, 75006 Paris, France; Neuroradiology Department, Sainte-Anne Hospital, 75014 Paris, France; INSERM U894, 75014 Paris, France
| | - Julien Wipff
- Paris Descartes University, Sorbonne Paris Cité, 75006 Paris, France; Rheumatology A Department, Cochin Hospital, APHP, 75014 Paris, France.
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Harlan N, Weaver LK, Deru K. Inaccurate pulse CO-oximetry of carboxyhemoglobin due to digital clubbing: case report. Undersea Hyperb Med 2016; 43:59-61. [PMID: 27000014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Newer pulse CO-oximeters provide a non-invasive and quick means of measuring oxyhemoglobin, carboxyhemoglobin and methemoglobin. Clubbing has been reported to cause inaccuracy in pulse oximeters. We present a case of inaccurate carboxy-hemoglobin measurement by pulse CO-oximetry due to digital clubbing. An 18-year-old man with a history of cystic fibrosis presented after a suicide attempt by inhalation of exhaust. At the initial emergency department evaluation, his blood carboxyhemoglobin was 33%. He was intubated, placed on 100% oxygen and transferred to our facility. Upon arrival, we placed three different pulse CO-oximeters on different fingers and toes. Carboxyhemoglobin levels measured by these meters ranged from 9%-11%. A venous blood gas drawn on arrival showed a carboxyhemoglobin level of 2.3% after four hours on 100% oxygen by endotracheal tube. Thirty minutes later, we checked arterial blood gas, which revealed a COHb level of 0.9%. Again, non-invasive carboxyhemoglobin measurements read 10%. The patient was treated with hyperbaric oxygen for carbon monoxide poisoning. This case suggests that non-invasive measurements of carboxyhemoglobin should be correlated with the clinic history and with an arterial or venous blood gas oximetry analysis.
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10
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Famularo G, Stasolla A, Gasbarrone L. Pachydermoperiostosis and bladder cancer. Dermatol Online J 2015; 21:13030/qt3fg1s6h7. [PMID: 26158372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 06/15/2015] [Indexed: 06/04/2023] Open
Abstract
Pachydermoperiostosis or the Touraine-Soulente-Golé syndrome is a rare monogenetic disorder characterized by pachydermia, periostosis and digital clubbing accounts for approximately 3∼5% of all patients with hypertrophic osteoarthropathy. Missense mutations in SLCO2A1 and HPGD genes could plausibly underlie the pathogenesis of pachydermoperiostosis. Patients have usually a favorable outcome with very few cases associated with cancer. Herein, we report the first case of a patient with pachydermoperiostosis associated with bladder cancer.
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Sandoval ARH, Flores-Robles BJ, Llanos JC, Porres S, Dardón JDP, Harrison RM. Cutis verticis gyrata as a clinical manifestation of Touraine-Solente-Gole' syndrome (pachydermoperiostosis). BMJ Case Rep 2013; 2013:bcr2013010047. [PMID: 23853021 PMCID: PMC3736327 DOI: 10.1136/bcr-2013-010047] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Cutis verticis gyrata is a descriptive term for a condition of the scalp consisting of deep grooves and convolutions that resemble the surface of the brain. We present a case of a 22-year-old man who presented with pain and swelling of both knees and hands. Enlarged wrists, ankles and feet were also noted, along with facial seborrhoea, thickening of the skin and deformity of the fingers. Physical examination of the scalp showed a cerebriform appearance with accentuating folds and deep furrows (cutis verticis gyrata), thickening in the face, frontal and parietal regions. Bone enlargement of the hands, knees, ankles and feet was also found. Secondary causes of pachydermoperiostosis were negative.
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Ding J, Li B, Chen T, Hao L, Li D. Eyelid thickening and ptosis associated with pachydermoperiostosis: a case report and review of literature. Aesthetic Plast Surg 2013; 37:464-7. [PMID: 23361957 DOI: 10.1007/s00266-013-0062-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2012] [Accepted: 12/16/2012] [Indexed: 11/29/2022]
Abstract
UNLABELLED The case of a 27-year-old Chinese patient with bilateral eyelid thickening and ptosis secondary to the rare condition of pachydermoperiostosis is presented. Surgical treatment was performed by horizontal tightening via a full-thickness wedge resection combined with levator shortening and advancement. Satisfactory aesthetic and functional results were achieved. The histopathology of eyelid tissue showed sebaceous gland hyperplasia and chronic inflammatory response. LEVEL OF EVIDENCE V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Jingwen Ding
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Science Key Lab, Capital Medical University, Beijing, 100730, China
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Chander R, Kakkar S, Jain A, Barara M, Agarwal K, Varghese B. Complete form of pachydermoperiostosis: a case report. Dermatol Online J 2013; 19:10. [PMID: 23473280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
Pachydermoperiostosis is a primary form of hypertrophic osteoarthropathy, which presents with pachydermia, digital clubbing, and radiologic periostosis. Pachydermoperiostosis occurs owing to mutations of the gene encoding for 15-hydroxyprostaglandin dehydrogenase (15HPGD). Clinical manifestations of PDP are thought to relate to excessive collagen formation and dysregulation of matrix proteins because of fibroblastic hyperactivation. We present a very rare case of the complete form of pachydermoperiostosis in a young Indian male.
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Affiliation(s)
- Ram Chander
- Lady Hardinge Medical College, New Delhi, India
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15
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Toelen C, Deleersnijder R, Thomas B. Malignant fibrous tumor of the pleura: case report and literature review. Acta Chir Belg 2012; 112:314-316. [PMID: 23008999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Solitary fibrous tumours (SFT) of the pleura are uncommon and are incidental findings or discovered in patients with non-specific respiratory symptoms. We report a case of a 74 year old man diagnosed with a mesenchymal pleural neoplasm, associated with typical hypertrophic osteoarthropathy, referred to as Pierre-Marie-Bamberg syndrome. As reported in the literature, complete surgical resection is the gold standard for treatment of such lesions and recurrences. Radiotherapy and chemotherapy are of limited value in the curative treatment of pleural SFT. In our case surgical excision of the mass was performed. After a disease-free period of 3 years a second intervention was necessary because of recurrence. Until now our patient is free of complaints and no signs of reappearance were noted. Based on our experience and on literature findings we would like to underline the importance of regular long-term follow-up because of the substantial risk of recurrence.
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Affiliation(s)
- C Toelen
- Department of Thoracic and Vascular Surgery, Sint-Augustinusziekenhuis, Wilrijk, Belgium.
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Guyot H, Sandersen C, Rollin F. A case of hypertrophic osteoarthropathy in a Belgian blue cow. Can Vet J 2011; 52:1308-1311. [PMID: 22654134 PMCID: PMC3215463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
A 12-year-old cow was presented with chronic respiratory disease and lameness. Chronic pleuritis, pneumonia, and bronchial carcinoma were found as well as periosteal proliferation on limb bones. Ancillary tests and necropsy confirmed a combined pathology of pulmonary inflammation and neoplasm, and hypertrophic pulmonary osteopathy.
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Affiliation(s)
- Hugues Guyot
- Faculty of Veterinary Medicine, Clinic for Ruminants, University of Liège, Boulevard de Colonster, 20 Bat. B42, 4000 Liège, Belgium.
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17
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Baroni A, Romano F. Tufted hair folliculitis in a patient affected by pachydermoperiostosis: case report and videodermoscopic features. Skinmed 2011; 9:186-188. [PMID: 21675501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
A 25-year-old man presented with Touraine-Solente-Golé syndrome (primary pachydermoperiostosis), with an area of inflammatory dermatosis (12-month evolution) of the scalp at the cranial vertex. The patient presented with arthropathy, clubbing of the digits, diffuse periostosis, pachydermia of the hands and feet, and periosteal hyperostosis of the knee. Facial seborrhea and sebaceous gland hyperplasia were evident (Figure 1A and 1B and Figure 2A and 2B). Examination of the scalp revealed an erythematous pruritic plaque with erosions, crusts, and pustules, on which multiple tufts of 10 to 20 normal-looking hairs emerged from single follicular openings (Figure 3A). Slight pressure on the perifollicular areas resulted in the discharge of purulent material through the dilated follicular openings. Cervical and occipital lymph nodes were not enlarged, and the patient was in generally good health. Routine laboratory findings were normal. Immunologic studies, including a screening for antinuclear antibody, complement, and immunoglobulins, were normal. Both potassium hydroxide staining and fungal culture were negative. Bacteriologic culture of purulent material taken from the affected area was positive for Staphylococcus aureus. Videodermoscopy of the lesion showed rarefied interfollicular twisted red loops centered around actively affected follicles and white dots with absence of normal vascular pattern (Figure 3B). These dermoscopy patterns are markers for folliculitis decalvans, of which tufted hair folliculitis (THF) is a clinical variant. Histologic examination showed hair plugging, a dense perifollicular infiltrate of plasma cells, lymphocytes, neutrophils, and large areas of scarring and fibrosis, which would confirm suspected THE THF was diagnosed on the grounds of clinical, microbiologic, histologic, and videodermoscopy data. The patient was treated with amoxicillin 875 mg plus clavulanic acid 125 mg twice daily and topical nadifloxacin 1% twice daily for 20 days, achieving substantial clinical improvement. One month after antimicrobial therapy, a single area of cicatricial alopecia with a few hair tufts emerging from single orifices was observed, and no new lesions or symptoms had appeared.
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Affiliation(s)
- Adone Baroni
- Department of Dermatology, Second University of Naples, Naples, Italy.
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Ninomiya S, Hara T, Tsurumi H, Kanemura N, Kasahara S, Ogawa Y, Seishima M, Hirose Y, Moriwaki H. Myelofibrosis successfully treated with prednisolone in a patient with pachydermoperiostosis. Intern Med 2011; 50:2207-11. [PMID: 21963742 DOI: 10.2169/internalmedicine.50.5717] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Pachydermoperiostosis (PDP) is a rare disorder of bone and connective tissue growth. A 21-year-old man was referred to our hospital with anemia. He showed characteristics of PDP. Bone marrow biopsy showed myelofibrosis. Chromosomal abnormalities or JAK2 mutation were not found. Anemia gradually progressed, and he became transfusion-dependent. Oral prednisolone was initiated; it gradually improved his anemia and rendered the patient free of transfusion. However, other clinical symptoms such as clubbed fingers and skin hypertrophy remained unimproved. In this case, the serum concentration of vascular endothelial growth factor and transforming growth factor-β levels were increased. Further investigation will be necessary to establish appropriate treatment strategies for this disease.
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Affiliation(s)
- Soranobu Ninomiya
- The First Department of Internal Medicine, Gifu University Graduate School of Medicine, Japan
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19
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Silva DDFR, Anunciação FAC, Carvalho LL, Budaruiche JS. [Vitiligo in a patient with pachydermoperiostosis: a fortuitous association?]. Acta Reumatol Port 2008; 33:364-367. [PMID: 18846015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Pachydermoperiostosis (PDP) is a rare hereditary disorder characterized by pachydermia, digital clubbing, arthritis and periosteal hypertrophy. We report the case of a patient with PDP who developed vitiligo. While the association of autoimmune diseases and some dermatological disorders with PDP has been reported before, this appears to be the first described case of vitiligo in association with PDP. The main clinical features of PDP are reviewed and the differential diagnosis is discussed.
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Kumar U, Bhatt SP, Misra A. Unusual associations of pachydermoperiostosis: a case report. Indian J Med Sci 2008; 62:65-68. [PMID: 18319534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Primary hypertrophic osteoarthropathy (HOA), or pachydermoperiostosis, is a rare benign disorder of unknown etiology. It is characterized by clubbing, periosteal reaction, and thickening of the skin. Disease usually progresses slowly, and natural arrest may occur. Reported herein is the case of a 28-year-old male patient with progressively increasing swelling of large joints of lower limbs with severe anemia. He was diagnosed as a case of pachydermoperiostosis with myelofibrosis, which is a rare association. The development of myelofibrosis makes primary HOA a disease with unfavorable outcome.
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Affiliation(s)
- Uma Kumar
- Department of Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
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Ukinc K, Ersoz HO, Erem C, Hacihasanoglu A, Ersoz S, Buran M. Pachydermoperiostosis with gynecomastia and osteoporosis: a rare case with a rare presentation. Int J Clin Pract 2007; 61:1939-40. [PMID: 17935552 DOI: 10.1111/j.1742-1241.2005.00748.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
- K Ukinc
- Department of Internal Medicine, Section of Endocrinology & Metabolism, Karadeniz Technical University, Faculty of Medicine, Trabzon, Turkey.
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Affiliation(s)
- Samuel Katsuyuki Shinjo
- Division of Rheumatology, Hospital das Clinicas, School of Medicine, University of São Paulo, São Paulo, Brazil.
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24
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Okten A, Mungan I, Kalyoncu M, Orbak Z. Two cases with pachydermoperiostosis and discussion of tamoxifen citrate treatment for arthralgia. Clin Rheumatol 2007; 26:8-11. [PMID: 16738844 DOI: 10.1007/s10067-005-1161-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2005] [Revised: 10/12/2004] [Accepted: 10/12/2004] [Indexed: 10/24/2022]
Abstract
Idiopathic hypertrophic osteoarthropathy is a rare syndrome, characterized by clubbing, progressive enlargement of the joints, coarse facial features suggesting acromegaly, palmoplantar hyperhidrosis, fibrous covering at the ends of long bones (periostosis), and acro-osteolysis. It is a self-limiting condition but arthralgia may be as severe as limiting social life and activity, and it is the main complaint to be treated. We report on two siblings with pachydermoperiostosis (PDP), one of whom had arthralgia. Although several drugs have been used, we used tamoxifen for his arthralgia and his complaint disappeared. To the best of our knowledge, this is the second case treated by tamoxifen reported in the literature.
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Affiliation(s)
- Aysenur Okten
- Department of Pediatrics, School of Medicine, Karadeniz Technical University, Pediatri Anabilim Dali, 61080 Trabzon, Turkey
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Ozdemir M, Yildirim S, Mevlitoğlu I. En coup de sabre accompanied by pachydermoperiostosis: a case report. Clin Exp Rheumatol 2007; 25:315-7. [PMID: 17543162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Scleroderma en coup de sabre, a variant of localized scleroderma is a disorder characterized by fibrosis of connective tissue. We report a 21-year-old female with scleroderma en coup de sabre accompanied by pachydermoperiostosis. She was born to consanguineous parents and her older sister also had pachydermoperiostosis characterized by clubbing of the digits, enlargement of distal parts of the extremities. The two disorders were diagnosed by clinical examination, histological and x-ray findings. In contrast to scleroderma, pachydermoperiostosis is a hypertrophic process characterized by periosteal proliferation of the tubuler bones and hypertrophic skin changes. We discuss this interesting coexistence and review the literature.
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Affiliation(s)
- M Ozdemir
- Department of Dermatology, Meram Medical Faculty, Selçuk University, Konya, Turkey.
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Abstract
A 20-month-old, entire male boxer dog was presented with lethargy and intermittent shifting limb lameness. Diagnostic tests revealed aortic valve vegetations suggestive of infective endocarditis causing severe aortic outflow obstruction, and hypertrophic osteopathy of all four limbs. The dog was treated symptomatically and euthanised four days later. The association of infective endocarditis and hypertrophic osteopathy has been poorly documented in the veterinary literature. The pathogenesis of hypertrophic osteopathy is unknown; however, four theories have been put forth to explain this disease: pulmonary shunting, vagal nerve stimulation, humoral substances produced by neoplastic cells and megakaryocyte/platelet clump hypothesis.
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Affiliation(s)
- M E Dunn
- Department of Clinical Sciences, University of Montreal, Québec, Canada
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Cinar F, Cinar S, Tekin N. Gradual nose enlargement: pachydermoperiostosis. Otolaryngol Head Neck Surg 2006; 135:168-9. [PMID: 16815208 DOI: 10.1016/j.otohns.2005.03.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2005] [Indexed: 11/28/2022]
Affiliation(s)
- Fikret Cinar
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Zonguldak Karaelmas University, Kozlu, 67600 Zonguldak, Turkey.
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Kebudi R, Ayan I, Görgün O, Ağaoğlu FY, Dizdar Y, Darendeliler E. Hypertrophic osteoarthropathy and intrathoracic Hodgkin's disease in children. Leuk Res 2006; 30:899-902. [PMID: 16310851 DOI: 10.1016/j.leukres.2005.10.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2005] [Revised: 10/19/2005] [Accepted: 10/22/2005] [Indexed: 10/25/2022]
Abstract
BACKGROUND Hypertrophic osteoarthropathy (HOA) is a syndrome characterized by clubbing of the fingers and toes, periosteal new bone formation of the long bones and polyarthritis. CASE REPORT In this report, two children with intrathoracic Hodgkin's disease and HOA are presented. CONCLUSIONS Intrathoracic neoplasms are one of the major causes of HOA in adults; however HOA is rarely associated with intrathoracic malignancies in children. HOA associated with intrathoracic Hodgkin's disease is even more rare, but should be kept in mind.
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Affiliation(s)
- Rejin Kebudi
- Istanbul University, Oncology Institute, Division of Pediatric Oncology, Turkey.
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30
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Younes M, Touzi M, Béjia I, Zrour-Hassen S, Amara N, Ben Hammouda M, Bergaoui N. Primary hypertrophic osteoarthropathy with bilateral destructive hip arthritis. Joint Bone Spine 2006; 73:477-9. [PMID: 16626991 DOI: 10.1016/j.jbspin.2005.11.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2005] [Accepted: 11/04/2005] [Indexed: 11/22/2022]
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Milchert M, Trzcińska-Butkiewicz B, Ostanek L, Bohatyrewicz A, Brzosko M. [Primary hypertrophic osteoarthropathy as a rare cause of joint pain]. Wiad Lek 2006; 59:873-8. [PMID: 17427508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Primary hypertrophic osteoarthropathy (HOA) is a rare cause ofjoint pain. The diagnosis is often delayed, due to mild complaints. However, finger clubbing combined with joint pain should suggest considering HOA in the diagnosis. The progression of toes and fingertips widening is slow and can be overlooked by a patient. It is common that patient seeks physician's aid only when the joint pain occurs. The presented case is an example of delayed diagnosis. Due to the fact that secondary HOA coexists with some diseases associated with serious prognosis it is recommended to exclude other possible causes before diagnosing primary HOA. Some clues, like the age of disease onset or positive family history allow the diagnosis of primary HOA with high probability. This case report contains clinical symptoms and new diagnostic criteria, differential diagnosis, and possible complications.
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Affiliation(s)
- Marcin Milchert
- Kliniki Reumatologii, Pomorskiej Akademii Medycznej w Szczecinie.
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Abstract
We describe a clinical case of a patient with pachydermoperiostosis and bilateral palpebral ptosis. It is a hereditary, dominant autosomic disease, which affects skin, bones and soft tissues. In the eyelid, it causes an important tarsal hypertrophy. We discuss the physiopathology and treatment of the ptosis.
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Affiliation(s)
- Ana Paula Ximenes Alves
- Departamento de Cirurgia, Faculdade de Medicina, Universidade Federal do Ceará, Ceará, Brazil.
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Appelhans C, Breuckmann F, Bastian A, Altmeyer P, Kreuter A. Fibromatosis of the hand associated with EMO syndrome: a case report. BMC Dermatol 2004; 4:17. [PMID: 15533248 PMCID: PMC529452 DOI: 10.1186/1471-5945-4-17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2004] [Accepted: 11/08/2004] [Indexed: 11/10/2022]
Abstract
BACKGROUND EMO syndrome, defined as a triad including exophthalmus, pretibial myxedema and osteoarthropathia, is a rare condition in patients suffering from hyperthyreosis. CASE PRESENTATION We here describe an interesting case of EMO syndrome associated with unilateral fibromatosis of the hand and an initial stage of generalized myxedema of the skin. To our knowledge a similar case has not yet been described in literature though reports about associated fibromatosis, e.g. located retroperitoneally, already exist. Familiar explanations include its initiation by autoimmune processes or aberrant T-cell cytokine stimulation leading to an overwhelming production of glycosaminoglycans. CONCLUSION Interpreting our case in context with previous reports we conclude that associated fibromatosis induced by autoimmune processes may affect a variety of different localizations and therefore requires careful monitoring. A therapeutical attempt by using UVA1 irridation for pretibial myxedema remained without a satisfying regression.
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Affiliation(s)
- Carolin Appelhans
- Dept. of Dermatology, Ruhr-University Bochum, Gudrunstr. 56, D-44791 Bochum, Germany
| | - Frank Breuckmann
- Dept. of Dermatology, Ruhr-University Bochum, Gudrunstr. 56, D-44791 Bochum, Germany
| | - Andreas Bastian
- Dept. of Internal Medicine, St. Josef Hospital Bochum, Gudrunstr. 56, D-44791 Bochum, Germany
| | - Peter Altmeyer
- Dept. of Dermatology, Ruhr-University Bochum, Gudrunstr. 56, D-44791 Bochum, Germany
| | - Alexander Kreuter
- Dept. of Dermatology, Ruhr-University Bochum, Gudrunstr. 56, D-44791 Bochum, Germany
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Ikeda F, Okada H, Mizuno M, Kawamoto H, Okano N, Okazaki H, Hamazaki S, Shiratori Y. Pachydermoperiostosis associated with juvenile polyps of the stomach and gastric adenocarcinoma. J Gastroenterol 2004; 39:370-4. [PMID: 15168249 DOI: 10.1007/s00535-003-1304-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2003] [Accepted: 08/04/2003] [Indexed: 02/04/2023]
Abstract
Pachydermoperiostosis (PDP) is a rare syndrome, and the presence of digital clubbing, radiographic periostosis, and coarse facial features are the main diagnostic criteria. Here, we report patient with the primary form of PDP in whom juvenile polyps and gastric cancer developed within 9 years of follow-up. A 27-year-old Japanese man, diagnosed as having the primary form of PDP at 14 years of age, was referred to our department for assessment of chronic anemia. On upper gastrointestinal endoscopic examination, multiple polypoid lesions with a huge polyp were found in the stomach, and biopsy findings indicated juvenile polyps, although no polypoid lesion had been present at the age of 18 years. Bleeding from these polyps was suspected, and endoscopic mucosal resection of the polypoid lesions was performed. Histology of the huge polyp showed hamartoma, adenoma, and adenocarcinoma in part. This is the first case report of the primary form of PDP associated with gastric cancer. In this patient, juvenile polyps and gastric cancer developed within 9 years of follow-up, indicating that the primary form of PDP may be a high risk factor for gastric cancer, and that periodical follow-up with upper gastrointestinal endoscopy is important.
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Affiliation(s)
- Fusao Ikeda
- Department of Medicine and Medical Science, Okayama University Graduate School of Medicine and Dentistry, 2-5-1 Shikata-cho, Okayama 700-8558, Japan
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Pichler G, Eber E, Thalhammer G, Muntean W, Zach MS. Arthralgia and digital clubbing in a child: hypertrophic osteoarthropathy with inflammatory pseudotumour of the lung. Scand J Rheumatol 2004; 33:189-91. [PMID: 15228191 DOI: 10.1080/03009740310004702] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Arthralgia in childhood is an unspecific symptom. One rare cause of arthralgia is hypertrophic osteoarthropathy associated with digital clubbing. We present a child where hypertrophic osteoarthropathy led to the rare diagnosis of an inflammatory pseudotumour of the lung. In a 12-year-old girl with arthralgia and digital clubbing, a chest radiograph disclosed a large round mass in the right upper lobe, and the following chest computed tomography scan showed a large solid homogenous, round, well marginated lesion with little contrast enhancement. A lobectomy of the right upper lobe was performed, and histological examination showed an inflammatory pseudotumour. The postoperative course was without problems: arthralgia and digital clubbing disappeared.
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Affiliation(s)
- G Pichler
- Division of General Paediatrics, Department of Paediatrics, University of Graz, Austria.
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36
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Marcilly MC, Balme B, Luaute JP, Skowron F, Bérard F, Perrot H. [Pachydermatodactyly associated with plantar pachydermy]. Ann Dermatol Venereol 2003; 130:777-80. [PMID: 14576609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
INTRODUCTION Pachydermodactyly is a superficial fibromatosis located on the proximal portion of fingers'phalanges and interphalangeal joints. Several types of this disease have been described depending on topography, etiology and pathological associations. We report a typical observation of pachydermodactyly associated with a plantar pachydermy. CASE-REPORT A 19 year-old man was followed for a psychotic disease, associated with mental retardation. On clinical examination, he showed a typical pachydermodactyly, predominantly located on the second, third and fourth fingers of both hands, associated with recent acrocyanosis. A pachydermic aspect was also observed on the external part of the feet sole. Histopathological analysis was identical on digital and plantar lesions with collagen swelling. These lesions extended into the subcutaneous fat only in the feet. DISCUSSION This observation is compatible with the most classical form of pachydermodactyly which involves several fingers of both hands, usually in men. Furthermore, the association with a psychiatric disorder and the notion of repeated traumatisms have been frequently reported in the literature. However, acrocyanosis and the important disability observed in our case are unusual. Association with plantar pachydermy has never been reported. The identical histological aspect on finger and feet sole suggests that pachydermatodactyly should be integrated in framework of acral pachydermy.
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Affiliation(s)
- M-C Marcilly
- Service de Dermatologie de l'Hôpital de l'Antiquaille, Lyon
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37
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Abstract
We report a case of a family with a variant form of primary hypertrophic osteoarthropathy (HOA) restricted to the lower extremities without digital clubbing or cutaneous changes. Three family members suffered from pain, swelling and hyperhidrosis of both feet. X-rays showed destruction and osteoproliferative changes of the metatarsal bones with periostal hyperostosis close to the talus. There was an increased 99m-Tc-MDP uptake in the early phase of bone scintigraphy. Fibrosis of the marrow with stimulated osteoclastic resorption and the presence of detritus synovialitis were visible in a bone and joint biopsy. All known infectious, neurologic, metabolic and malignant diseases, which affect the bone and joints, were excluded.
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Affiliation(s)
- Ruth Seggewiss
- Department of Internal Medicine V, University of Heidelberg, Hospitalstr. 3, 69115, Heidelberg, Germany.
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Smit F, Valdés Olmos RA, Sivro-Prndelj F, Hoefnagel CA. Hypertrophic osteoarthropathy on bone scintigraphy related to a mediastinal tumour of unknown origin imaged by FDG-PET. Eur J Nucl Med Mol Imaging 2003; 30:332. [PMID: 12552357 DOI: 10.1007/s00259-002-1088-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- F Smit
- Department of Nuclear Medicine,The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands.
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Abstract
A 33-year-old man, suffering from cutaneous psoriasis since the age of 16, in the last 6 years experienced slow and painless enlargement at his fingertips and later at his big toes, which resulted in digital clubbing. Since the age of 31, the patient also presented psoriatic nail changes involving all his fingernails, without joint pain or inflammation. The patient's family history was negative for psoriasis, however, his brother, a 29-year-old healthy man, also presented digital clubbing. The diagnosis of pachydermoperiostosis coexistent with ungual and cutaneous manifestations of psoriasis vulgaris was made. The differential diagnosis with psoriatic onycho-pachydermo-periostitis, as well as other clinical conditions that involve the distal interphalangeal joints is discussed.
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Affiliation(s)
- P Fietta
- Dipartimento Osteo-Articolare, Unità Operativa di Reumatologia e Medicina Interna, Azienda Ospedaliera di Parma, Via Gramsci, 14, 43100 Parma, Italy
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Abstract
Congenital megaesophagus is often sufficiently debilitating to a young puppy to result in an owner's request for euthanasia. If medically managed, some puppies may develop a functional esophagus and mature normally; in others, the dilation may persist, but nutritional support may be sufficient to allow skeletal maturation. Hypertrophic osteoarthropathy or hypertrophic osteopathy is well recognized in many animal species. Pulmonary neoplasia is most commonly associated with development of the secondary bone changes, but numerous other causes exist. The chronic changes of hypertrophic osteopathy were identified in a 6-year-old German Shepherd that was debilitated by persistent congenital megaesophagus. To the investigators' knowledge, a relationship between long-term esophageal dilatation and hypertrophic osteopathy has only been reported once in a human patient.
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Affiliation(s)
- Barbara J Watrous
- Department of Large Animal Clinical Sciences, Oregon State University, Corvallis, OR 97331-4802, USA
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Abstract
A 39-year-old man with pachydermoperiostosis is presented. He had enlarged, thickened upper eyelids that made it difficult for him to open his eyes. Eyelid correction was performed by resecting the excessive skin and orbicularis muscle in a fusiform shape and shortening the levator aponeurosis by plication. A wedge resection of the lateral third of the upper lid shortened the horizontal width and also changed the unpleasant fan shape to a better shape, with a natural curvature of the lid. The authors also performed a 5-mm transconjunctival tarsectomy. Visual impairment was corrected with a satisfactory aesthetic outcome.
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Affiliation(s)
- Atilla Arinci
- Department of Plastic and Reconstructive Surgery, Istanbul University, Istanbul Medical Faculty, Ataköy 9, Kisim B1 blok D:56, 34750 Ataköy, Istanbul, Turkey
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Abstract
It is rare to find congenital cardiac disease in association with familial primary hypertrophic osteoarthropathy. We have now encountered three siblings, two of whom had digital clubbing, patent arterial ducts and delayed closure of the cranial fontanels. The third infant was unusual in that there was no clubbing, or cranial abnormality, despite a small ventricular septal defect. To the best of our knowledge, this association has not previously been observed.
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Affiliation(s)
- Solomon E Levin
- Division of Paediatric Cardiology, Johannesburg Hospital, Faculty of the Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
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43
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Akdeniz BG, Seçkin T. Periodontal and alveolar bone abnormalities associated with pachydermoperiostosis. Periodontal Clin Investig 2002; 23:5-10. [PMID: 11575112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
Pachydermoperiostosis (PDP) is an unusual syndrome manifested clinically by finger clubbing, extremity enlargement, hypertrophic skin changes, and periosteal bone formation. A rare case of pachydermoperiostosis (primary hypertrophic osteoarthropathy) with oral manifestations in a 47-year-old man is presented. The possible correlation between physiological mechanisms of this disease and their influence on oral periodontal tissues and alveolar bone is discussed.
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Affiliation(s)
- B G Akdeniz
- Department of Oral Diagnosis and Radiology, School of Dentistry, Ege University, Izmir, Turkey
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44
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Jajíc I. Nails 'obstructing' finger growth in length in primary hypertrophic osteoarthropathy (PHO). Clin Rheumatol 2001; 19:398. [PMID: 11055833 DOI: 10.1007/s100670070037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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45
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Dosik JS. Psoriatic onycho-pachydermo-periostitis. Dermatol Online J 2001; 7:11. [PMID: 11328632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
Affiliation(s)
- J S Dosik
- Department of Dermatology, New York University, USA
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46
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Jajic Z, Grazio S, Nemcic T, Jajic I. Reactivation of primary hypertrophic osteoarthropathy by bronchogenic carcinoma. Clin Exp Rheumatol 2001; 19:95-7. [PMID: 11247336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
This paper reports 2 cases of primary hypertrophic osteoarthopathy (PHO) which evolved into secondary hypertrophic osteoarthopathy (SHO) under the influence of bronchogenic carcinoma. The patients had a clinical picture of primary hypertrophic osteoarthropathy but without any signs of disease activity until in the last several months when a malignant bronchopulmonary condition developed. This activated all the symptoms: joint swelling; enlarged fingers and distal forearms and legs; moist palms and soles; unpleasant odour of perspiration; and deeper folds of the forehead and nasolabial furrow. A bone scan showed increased accumulation of the radioisotope in specific regions of the skeleton. To our knowledge, no similar cases have been described in the literature.
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Affiliation(s)
- Z Jajic
- Department for Rheumatology, Physical Medicine and Rehabilitation, Sestre Milosrdnice University Hospital, Zagreb, Croatia
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Di Cataldo A, Villari L, Milone P, Miano AE, Sambataro MP, Florio G, Petrillo G. Thymic carcinoma, systemic lupus erythematosus, and hypertrophic pulmonary osteoarthropathy in an 11-year-old boy: a novel association. Pediatr Hematol Oncol 2000; 17:701-6. [PMID: 11127403 DOI: 10.1080/08880010050211420] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Thymic carcinoma is exceptionally rare in children and it has never previously been associated with autoimmune disorders. The authors report the case of an 11-year-old boy with thymic carcinoma, hypertrophic pulmonary osteoarthropathy, and an autoimmune disease that resembled systemic lupus erythematosus. To their knowledge, this is the first case of such complex clinical findings. The tumor was of high grade histologically and the boy died after 1 year, in spite of chemotherapy and radiotherapy. A review is presented of the available medical literature on thymic malignancy in childhood.
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Affiliation(s)
- A Di Cataldo
- Department of Paediatric Haematology/Oncology, University of Catania, Catania, Italy.
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Guyot-Drouot MH, Solau-Gervais E, Cortet B, Deprez X, Chastanet P, Cotten A, Delcambre B, Flipo RM. Rheumatologic manifestations of pachydermoperiostosis and preliminary experience with bisphosphonates. J Rheumatol 2000; 27:2418-23. [PMID: 11036839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
OBJECTIVE Pachydermoperiostosis is manifested by finger clubbing, hypertrophic skin changes, and periosteal bone formation. We describe 5 cases revealed primarily by their rheumatologic manifestations. Also reported are preliminary experiences on the use of intravenous pamidronate as a treatment. METHODS This is a retrospective study including the analysis of clinical manifestations, laboratory results and morphological examinations gathered from patients' medical records. We evaluated efficacy of treatment with 1 mg/kg iv pamidronate in the 3 new cases. RESULTS Before treatment with iv pamidronate, the patients' global assessment was poor (twice) and very poor (once). The physician's global assessment was poor in 3 patients. After treatment with iv pamidronate, 2 patients had significant improvement. Physician and patient global assessments were very good, good, and moderate. No side effects were observed. All biological variables were within normal ranges at 12 month followup visit. CONCLUSION Pachydermoperiostosis must be recognized by the rheumatologist, since it can present symptomatically through articular manifestations. When conventional treatment modalities fail, iv pamidronate might be useful.
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Affiliation(s)
- M H Guyot-Drouot
- Service de Rhumatologie, Hôpital Roger Salengro, CHU Lille, France
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Maeda H, Kumagai K, Konishi F, Katayama Y, Hiyama K, Ishioka S, Yamakido M. Successful treatment of arthralgia with tamoxifen citrate in a patient with pachydermoperiostosis. Rheumatology (Oxford) 2000; 39:1158-9. [PMID: 11035143 DOI: 10.1093/rheumatology/39.10.1158] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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