Acropathia ulcero-mutilans acquisita of the upper limbs

[Hand involvement in Thevenard's disease: a new "phlegmonous" form. An exceptional case report]

Thévenard's disease is a rare familial ulcero-mutilating acropathology involving the peripheral nervous system. It typically begins on the feet and only rarely spreads to the hands late in the course of the disease. It first causes cutaneous ulcerations and then secondary osseous deformations and osteoarticular destruction, due to a distal loss of temperature sensation. We report the case of an 87 year old patient who suffered from a particular clinical form, undescribed as yet in the literature and characterized by local and general superinfections predominately on the hands. We term this the "cellulitic" presentation or form of Thévenard's disease.

[Bureau-Barrière syndrome of the hand. A case report on an unusual localization]

The Bureau-Barrière syndrome is described as an acral ulcer with mutilating osteolysis of the limbs that is nonfamiliar, non-sex-specific, induced by many factors, and elicited by sensory-trophic polyneuropathy. Often a bilateral location at the lower limb of male alcoholics has been described. We report about a 76-year-old diabetic women with unilateral mutilating acroosteolysis and ulceration of one finger and discuss the relevant clinical aspects of the Bureau-Barrière syndrome.