A novel association of pseudoainhum and epidermolytic ichthyosis, successfully treated with full thickness skin graft after failed z-plasty repair

Pseudoainhum is a rare constriction band variant thatmay progress to spontaneous digital strangulationand auto-amputation. Although its association withpalmoplantar keratodermas is well established, ithas not been reported in conjunction with classicepidermolytic ichthyosis. We describe the first suchcase in a 25-year-old woman who presented witha painful constricting band of the fifth toe. We alsodescribe her treatment course, which consisted ofa failed z-plasty, the traditional therapeutic optionfor acute pseudoainhum, and report the success ofsubsequent full thickness skin graft, suggesting thebenefit of this procedure as a therapeutic alternativefor patients with pseudoainhum.

Dactylolysis spontanea or ainhum involving the big toe

We describe the case of an Italian Caucasian man with ainhum involving both big toes. Ainhum or dactylolysis spontanea is characterized by the development of a constricting band around a toe, which progresses to spontaneous autoamputation. It usually affects the fifth toe bilaterally, but in rare cases other toes may be involved. The disease occurs in Black people living in tropical regions but occasionally has been reported in persons having fair skin.

Pseudoainhum in chronic psoriasis

Pseudoainhum is a term used to describe the presence of constricting bands of the extremities due to a variety of underlying causes. Progression of the lesions can cause irreversible damage and autoamputation of the affected digit. This report documents a rare association of pseudoainhum and psoriasis and emphasizes the importance of recognizing this condition.

Lamellar ichthyosis associated with pseudoainhum of the toes and eye changes

Classic lamellar ichthyosis is a rare, autosomal recessive, genetically heterogeneous skin disease caused by mutations in the transglutaminase 1 gene. Pseudoainhum is characterized by the appearance of a constricting band around a digit which may lead to spontaneous amputation. We describe a 41-year-old man with classic lamellar ichthyosis with unusual eye changes and pseudoainhum of both the fifth and the third right toes. Eye abnormalities included bilateral ectropion of the lower eyelids, chronic blepharitis, and nuclear cataract. A radiometric assay revealed greatly reduced skin transglutaminase activity. To the best of our knowledge, this report is unique as classic lamellar ichthyosis with deficient transglutaminase activity has never been associated with pseudoainhum of the toes and the early development of nuclear cataract.

Digital constriction bands in pseudoainhum: morphological radiographic, and histological analysis

Pseudoainhum is a rare condition of unknown etiology that produces digital constricting rings, most commonly on the small fingers. A thorough discussion of pseudoainhum in the plastic surgical literature is apparently lacking at this time. The authors describe the gross morphology, radiographic and laboratory features, and surgical pathology of the disease, and provide well-defined guidelines for its treatment.

Pseudo-ainhum, angiodysplasia and focal acral hyperkeratosis

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[Ainhum]

Ainhum is an ancient disease described in 1821 by Messum and its origin is still unknown. It is a tropical or semitropical disease seen in Blacks, Whites and Indians which affects the 5th and sometimes the 4th toe and causes spontaneous amputation. Females are more often affected than males, and there is a tendency to geographical clustering of cases and familial occurrence.

Successful treatment of keratoderma hereditaria mutilans with an aromatic retinoid

Clinical features and treatment of keratoderma hereditaria mutilans (Vohwinkel's syndrome) are described in an 11-year-old boy. The disease, in particular the mutilating complications (pseudo-ainhum), responded satisfactorily to the oral administration of etretinate, an aromatic retinoid.

[Ainhum and a pseudo-ainhum syndrome. Overview with 2 case reports]

In a case of a 26-year-old African Ainhum-Syndrome is reported and compared with a Pseudo-Ainhum-Syndrome by a 44-year-old German woman with chronical Polyneuropathy. Short description of both syndromes.

Observations and speculations

During 25 years of private practice in East Griqualand I have made a number of observations, mostly on Black patients, which may be of interest to readers, and I would also like to put forward a few speculations about disease as seen in the Black.

[Keratosis lichenoides striata associated with a pseudo-sinhum and a neurological picture (author's transl)]

The authors reported a case which does not seem to be possibly related to any known clinical entity; an aspect of keratosis lichenoides striata is associated with an ichthyosiform condition of the trunk and a pseudo-ainhum; there is also a neurological syndrome similar to a multilocular sclerosis. This patient resembles the previous cases of the literature; however there is neither erythema nor any striation at the back of the knees. There is also a pseudo-ainhumm. Concerning this observation, a review of the literature on keratosis lichenoides striata is presented.