We report the case of a 16-year-old man with a personal history of allergic asthma and a family history of psoriasis who came to our consultation due to the appearance of stable lesions of the tumor type, practically asymptomatic, in the right dorsum and lateral face of both hands.
She did not report any clinical symptoms or other lesions on the rest of her body surface.
After a detailed anamnesis, the patient reported performing movements of the friction between his fingers in a habitual way, which he described as "mania".
Physical examination revealed bilateral thickening of the periarticular tissue at the level of proximal interphalangeal joints in all fingers of both hands, except for the first finger, with firm consistency, not painful to the seal.
There was no evidence of hyperkeratosis or loss of substance.
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Blood count, basic biochemistry and autoimmunity study were performed, which was normal. An X-ray of both hands showed an increase in the thickness of adjacent soft tissues affected by the interphalangeal joints without clinically proximal alterations.
Because of the invasiveness of the procedure and the absence of complications, we decided not to perform a biopsy due to the typical clinical presentation and the complementary tests data.
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With all these data, our diagnostic impression was pachydermodactilia.
The benign nature of the process was maintained under observation with conservative measures.
The importance of repeated traumatisms in the process was explained to the patient and their relatives and it was suggested to their reference pediatrician the evaluation by a psychologist if the behavior persisted.
He came to the clinic one month later without changes, with stable lesions and without associated symptoms.
She was discharged after ruling out another accompanying pathology.
