A patient presents to you with clubbing of fingers; hyperhidrosis; and thick, furrowed, and redundant skin on his forehead, cheeks, and chin. What is the diagnosis?
Ans. c. Pachydermoperiostosis
A syndrome that combines hypertrophic osteoarthropathy and acromegalic features.
Patients with this disorder have cylindrical thickening of the limbs due to periostitis and skin changes.
The hereditary form of pachydermoperiostosis may be inherited as an autosomal dominant trait with incomplete penetrance and is most severe in males. Its onset usually occurs in the late teens.
The acquired form is not associated with a family history of the disorder, usually occurs in older men, and is associated with coexisting chronic cardiopulmonary or gastrointestinal neoplasm or infection.
- Marked thickening and oiliness of the skin of the hands, forearms, and legs;
- Accentuation of facial folds
- Hyperhidrosis of the hands and feet
- Reduplication and furrowing of skin over the scalp (called cutis verticis gyrata, or “bulldog scalp”).
There may also be macroglossia.