Presentation
We are reporting a case of complete Pachydermoperiostosis with blepharoptosis as a presenting complaint. [djo.org.in]
Presented in ten chapters from anatomy and differential diagnoses to surgical interventions, this book shows the latest surgical techniques firstly through line drawings before moving to clinical photographs of the techniques. [books.google.de]
This present pregnancy was a spontaneous conception with adequate folic acid supplementation. [jcnonweb.com]
Skin
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Keratosis
p63 gene mutations in EEC syndrome, limb-mammary syndrome, and isolated split handfoot malformation suggest a genotype-phenotype correlation. 151 ページ - Follicular keratosis and verrucous lesions on the extensor surfaces of the arms and legs and on [books.google.com]
Keratosis palmoplantaris punctata (Buschke-Fischer-Brauer) is a rare genodermatosis with a reported incidence of 1.2/100,000. [tfcxiw.co]
Dermatological examination showed increased sebaceous hyperplasia with horizontal furrowing on the forehead and palmoplantar keratosis. Radiographs of forearm revealed a cortical thickening bilaterally in radius and ulna. [jiaomr.in]
Workup
Subsequent workup was consistent with a diagnosis of the complete form of primary hypertrophic osteoarthropathy also known as pachydermoperiostosis. [omicsonline.org]
Shuhaila Shahril, a Consultant Physician and Rheumatologist, Dr Malehah Mohd Noh, a clinical fellow in rheumatology and Dr Nazatul, a Consultant Dermatologist who have played instrumental role in the care of this patient and facilitated the diagnostic workup [edmcasereports.com]
Urine
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Albuminuria
There was no albuminuria. Ultrasonography of abdomen and electrocardiogram (ECG) were normal. CT scan of abdomen and chest was done to rule out causes of secondary PDP. Radiological consultation was done. [djo.org.in]
Treatment
Make the best clinical decisions with an enhanced emphasis on evidence-based practice and expert opinions on treatment strategies. Zero in on the most relevant and useful references with the aid of a more focused, concise bibliography. [books.google.com]
The proposed treatment was facial rhytidectomy, which was to be performed in two stages. [rbcp.org.br]
The treatment is unsatisfactory. We tried bisphosphonates in its treatment with encouraging results. We suggest that injectable bisphosphonates should be tried early in treatment of Pachydermoperiostosis. [austinpublishinggroup.com]
Elevated level of urinary PGE2 is also used as an early laboratory marker for PHO. [10] Treatment involves nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids for relieving pain and swelling. [jcnonweb.com]
Prognosis
Prognosis - Pachydermoperiostosis Not supplied. Treatment - Pachydermoperiostosis Not supplied. Resources - Pachydermoperiostosis Not supplied. [checkorphan.org]
All patients need reassurance about good prognosis. Conclusion Primary hypertrophic osteoarthropathy is a rare familial disorder. There are individual case reports in literature with no history of family involvement. [jpma.org.pk]
• Onset is in adolescence- presenting as enlargement of distal extremities and clubbing• Skin and bone changes become apparent by 5- 20 years and remain unchanged throughout life• Prognosis- patient may develop functional or cosmetic complications, [slideshare.net]
The prognosis ultimately depends on the underlying disease. Treatment is symptomatic. Our patient had the complete form of pachydermoperiostosis, since he had hyperostosis, finger clubbing, and pachydermia. 1. Bhaskaranand K, Shetty RR, Bhat AK. [idoj.in]
Prediction and prevention pachydermoperiostosis In most cases, an unfavorable prognosis pachydermoperiostosis - specific treatment of the disease does not exist, and its manifestations have a tendency to progression. [medicalformat.com]
Etiology
Year introduced: 2014(1964) PubMed search builder options Subheadings: analysis anatomy and histology blood chemically induced classification complications congenital diagnosis diagnostic imaging drug therapy enzymology epidemiology ethnology etiology [ncbi.nlm.nih.gov]
It is the most rare, and its etiology is still unclear - according to some sources, it can be as options HPGD mutations and other damage has not yet identified genes. [medicalformat.com]
A work-up disclosed no organic etiology. The final diagnosis consisted of pachydermoperiostosis syndrome. [jmedicalcasereports.biomedcentral.com]
classic or complete form, with skin and skeletal changes; incomplete form, with skeletal changes but no dermal findings; and forme fruste with dermal changes but no skeletal findings. [3] The etiology of primary HOA is still unclear; however, several [jiaomr.in]
[…] patient, [9] a Korean family, [12] and a Chinese family [13] have been documented, as have a novel nonsense mutation p.E141* of the SLCO2A1 gene in a Japanese one [14] and a novel homozygous truncating mutation in HPGD described in Turkey. [15] References Etiology [misc.medscape.com]
Epidemiology
Year introduced: 2014(1964) PubMed search builder options Subheadings: analysis anatomy and histology blood chemically induced classification complications congenital diagnosis diagnostic imaging drug therapy enzymology epidemiology ethnology etiology [ncbi.nlm.nih.gov]
Hata and Onouchi (2009) reviewed current knowledge on Kawasaki disease, including epidemiology, genomewide linkage analysis, and molecular genetics. [mendelian.co]
[…] usually progresses for 5 to 20 years, until it becomes stable. [1] Life expectancy may be normal, despite patients getting many functional and cosmetic complications, including restricted motion, neurologic manifestations and leonine facies. [1] [5] Epidemiology [en.wikipedia.org]
[…] generally known to result in secondary hypertrophic osteoarthropathy (Crohn disease, myelofibrosis, and congenital cardiac disease) have been reported to develop in patients with pachydermoperiostosis or primary hypertropic osteoarthropathy. [34] References Epidemiology [misc.medscape.com]
Pathophysiology
Pathophysiology• Not completely understood• Role of PGE2- – high levels of PGE2 have been observed in PDP – PGE2 can mimic the activity of osteoblasts and osteoclasts. [slideshare.net]
[…] inheritance. [1] Two genes have been associated with this condition: hydroxyprostaglandin dehydrogenase 15-(NAD) ( HPGD ) and solute carrier organic anion transporter family, member 2A1/ prostaglandin transporter ( SLCO2A1 ). [38] [39] [40] The underlying pathophysiology [en.wikipedia.org]
References Pathophysiology As reported in 2008, pachydermoperiostosis or primary hypertropic osteoarthropathy has been mapped to band 4q33-q34. [misc.medscape.com]
Prevention
Meticulous systemic examination in such cases helps in identifying this disorder and preventing complications. References F riedrich N. Hyperostose des gesammten skelettes. Virchows Arch Pathol Anat 1868; 43:83. U nna PG. Cutis verticis gyrata. [djo.org.in]
Increased levels of interleukin 6 and receptor activator of nuclear factor–kappaB ligand (RANKL) have been reported in the serum of a patient with pachydermoperiostosis or primary hypertropic osteoarthropathy during the acute phase of the disease Prevention [checkorphan.org]
Prevention pachydermoperiostosis possible only within the framework of genetic counseling prior to conception and prenatal genetic diagnosis. [medicalformat.com]
[…] the rate at which minerals are deposited into boneHP:0100526Neoplasm of the lungMP:0014179abnormal blood-retinal barrier functionanomaly in the function of the part of the blood-ocular barrier that consists of cells that are joined tightly together to prevent [pediascape.org]
It is indicated for prevention or treatment of osteoporosis. References Class Summary These agents inhibit osteoclastic bone resorption. References Tamoxifen (Nolvadex, Tamofen, Tamone) Dosing, Interactions, etc. [misc.medscape.com]