厚皮指症  

PACHYDERMODACTYLY

作　　者：李发菊[1] 陈洁[1] 张玉高[1] 赵毅[1] 何成松[1] 

机构地区：[1]泸州医学院附属医院风湿免疫科,四川泸州646000

出　　处：《泸州医学院学报》2009年第4期363-365,共3页Journal of Luzhou Medical College

摘　　要：目的:总结厚皮指症的临床特点,提高对厚皮指症的认识,减少误诊误治。方法:分析6例患者的临床资料、关节受累情况、实验室检查、X线平片和核磁共振成像、组织病理改变及诊治经过并随访。结果:男性5例,女性1例,平均年龄:16.3±1.8岁。主要表现为双手对称性近端指间(PIP)关节两侧无症状性软组织扁平梭形膨大。实验室检查未发现异常;6例双手X线检查均见受累关节周围软组织肿胀;1例左手核磁共振成像见:近端指间关节周围软组织增厚;1例左手第5PIP关节膨大处软组织活检见:表皮过度角化,真皮层纤维组织增生。院外2例诊断不明,3例误诊为"类风湿关节炎"予中成药或中草药治疗半个月～1个月停药。6例诊断厚皮指症后未治疗,5例随访5～26(13.9±9.2)个月,病情无明显变化。结论:厚皮指症的诊断主要依据特征性临床表现;多因素参与厚皮指症的发生;易误诊甚至误治;该病呈良性经过,无需特殊治疗。Objective：To summarize clinical features of pachydermodactyly and decrease misdiagnosis. Methods：The clinical data of 6 pachydermodactyly cases including laboratory tests, condition of involved joints, manifestation of imaging and histopathology were collected.Results：The mean age of onset was 16.3±1.8 year, 5 male and 1 female. After experienced a delitescence course, the major manifestations of bilateralis non-inflammatory fusiform intumescentiae swelling of proximal interphalangeal （PIP） joints were observed. Abnormal laboratory tests were not found in all patients. X-ray showed soft tissue swelling at involved joints in all patients and MRI showed pachyderma in 1 patients. Epiderm hyperkeratosis and subcuticula fibroplasias were found at PIP 5 joints in 1 patient. Two cases were diagnosed unknown and 3 patients were diagnosed with rheumatoid arthritis and treated with traditional Chinese medicine. After final diagnosis, all of them stopped therapying. No change were found in 13.9±9.2 months follow-up. Conclusion：The diagnosis of pachydermodactyly depends on clinical manifestations.Multiple factors beget the disease. For a well prognosis, pharmacal therapy is not necessary.

关 键 词：厚皮指症 诊断 误诊 

分 类 号：R593.2[医药卫生—内科学]