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Symptomatic pachydermodactyly: A case report.

Mod Rheumatol Case Rep

January 2025

Department of Rheumatology Research, Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, Kanagawa, Japan.

Pachydermodactyly, an uncommon variant of digital fibromatosis, predominantly affects young men and results in fibrous swelling on the sides of the proximal interphalangeal joints. It is generally considered benign and asymptomatic, requiring only regular follow-up. Nevertheless, the absence of established diagnostic criteria has led to misdiagnoses, prompting the administration of unnecessary medications.

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Pachydermodactyly, mimicker of rheumatoid hands, presents in a patient with Tuberous Sclerosis.

Pak J Med Sci

January 2023

Dr. Roshila Shamim, FCPS (Medicine), FCPS (Rheumatology). Karachi, Pakistan.

Pachydermodactyly (PDD) is a rare benign condition characterized by painless soft tissue swelling of small joints of hands. The most common presentation is bilateral Symmetrical swelling of proximal interphalangeal and metacarpophalangeal joint similar to Rheumatoid arthritis. The etiology of this disease is unknown, and it sometimes can coexist with other diseases.

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Arthritis in the paediatric population is the hallmark of many rheumatic inflammatory diseases, as well as other cutaneous, infectious, or neoplastic conditions. It can be quite devastating, whereby prompt recognition and treatment of these disorders are essential. However, arthritis can sometimes be mistaken for other cutaneous or genetic conditions leading to misdiagnosis and overtreatment.

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An otherwise healthy young man was referred to the rheumatologist because of bilateral proximal interphalangeal (PIP) joint enlargements. The main concern was excluding the presence of inflammatory arthritis. Physical examination revealed bilateral PIP finger joints (II-IV) swellings and cutaneous thickenings in adjacent areas.

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Pachydermodactyly (PDD), meaning "thick skin finger" in Greek, is a rare, noninflammatory, benign, superficial fibromatosis. We report the case of PDD in a 15-year-old boy who visited our clinic because of asymptomatic swelling of the proximal interphalangeal (PIP) joints on the third finger of both left and right hands. Physical examination revealed thickening of the skin in the radial and ulnar aspects of the PIP joints of his third finger of both hands without functional limitation or neurological symptoms.

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