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    1 OF 17

    Primary Idiopathic Osteoarthropathy: Could It Be Related to Alcoholism?
    Case Rep Rheumatol 2017 2;2017:2583762. Epub 2017 Jan 2.
    Internal Medicine Department, Hurley Medical Center, Flint, MI, USA.
    Background. Hypertrophic osteoarthropathy (HOA) is a syndrome characterized by abnormal proliferation of the skin and bony structures at the distal extremities resulting in digital clubbing, periosteal bony reaction, and joint effusion. It can be primary (idiopathic) without any clear identifiable etiology as well as secondary to variety of systemic diseases most notably lung pathology. Read More

    A rare case of pachydermoperiostosis associated with blepharoptosis and floppy eyelids.
    Indian J Ophthalmol 2016 Dec;64(12):938-940
    Department of Orbit Oculoplasty Reconstructive and Aesthetic Services, Sankara Nethralaya, Medical Research Foundation, Chennai, Tamil Nadu, India.
    Pachydermoperiostosis (PDP) is a multisystem disorder of mesenchymal origin. It is a form of hypertrophic osteoarthropathy. The typical clinical features include pachydermia, cutis verticus gyrata, digital clubbing, and periostosis. Read More

    Hypertrophic Osteoarthropathy: Clinical and Imaging Features.
    Radiographics 2017 Jan-Feb;37(1):157-195. Epub 2016 Dec 9.
    From the Department of Radiology, Keck School of Medicine, University of Southern California, 1500 San Pablo St, 2nd Floor Imaging, Los Angeles, CA 90033 (F.Y.Y., D.B.P., A.J.S., E.A.W., A.T., G.R.M.); Department of Radiology, Southern California University of Health Sciences, Whittier, Calif (M.R.S.); and Department of Radiology, Greater Los Angeles Veterans Affairs Medical Center, Los Angeles, Calif (S.M.).
    Hypertrophic osteoarthropathy (HOA) is a medical condition characterized by abnormal proliferation of skin and periosteal tissues involving the extremities and characterized by three clinical features: digital clubbing (also termed Hippocratic fingers), periostosis of tubular bones, and synovial effusions. HOA can be a primary entity, known as pachydermoperiostosis, or can be secondary to extraskeletal conditions, with different prognoses and management implications for each. There is a high association between secondary HOA and malignancy, especially non-small cell lung cancer. Read More

    Tarsal Glandular Hyperplasia in Pachydermoperiostosis and Implications for Ptosis Correction.
    Ophthal Plast Reconstr Surg 2016 Oct 11. Epub 2016 Oct 11.
    *Division of Oculoplastic and Orbit, Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery; and †Department of Pathology, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
    Pachydermoperiostosis is a rare genetic disease that causes major bone and skin changes. Severe ptosis is a prominent finding in this peculiar condition. We report here 2 patients with typical features of pachydermoperiostosis. Read More

    J Assoc Physicians India 2016 Mar;64(3):88-89
    Associate Professor, Mahatma Gandhi University of Medical Sciences and Technology, Jaipur, Rajasthan.
    A case of Pachydermoperiostosis (PDP) presented to us in rheumatology clinic with complaints of enlargement and broadening of bilateral hands and feet, grade IV digital clubbing, coarsening of facial features, excessive sweating of the palms, soles during summers. Read More

    Homozygous SLCO2A1 Translation Initiation Codon Mutation in a Pakistani Family with Recessive Isolated Congenital Nail Clubbing (ICNC).
    Br J Dermatol 2016 Sep 28. Epub 2016 Sep 28.
    Human Medical Genetics and Genomics Program.
    Isolated congenital nail clubbing (ICNC; OMIM 119900) is a rare genodermatosis in which bilateral, symmetric enlargement of the nail plate and terminal segments of fingers and/or toes results from excessive proliferation of connective tissue between the nail matrix and distal phalanx. Loss of the normal angle between the nail and posterior nail fold is associated with a shiny, hypoplastic, thick-ended, long, broad nail. The thumbs are almost always involved, though some fingers or toes may be spared. Read More

    Laxative Related Primary Hyperphosphatemic Tumoral Calcinosis Identified by Bone Scintigraphy.
    World J Nucl Med 2016 Sep;15(3):200-2
    Department of Nuclear Medicine, Fremantle Hospital, WA 6160, Australia.
    We describe a case of a 40-year-old female patient presenting with tumor calcinosis where hypertrophic pulmonary osteoarthropathy (HPOA) was suspected given her extensive history of malignancy. Plain X-rays did not show reveal the typical periarticular calcification but did show appearances consistent with HPOA. Bone scintigraphy with (99m)Tc-methylene diphosphonate (MDP) is a sensitive investigation in the detection of hypertrophic osteoarthopathy but did not show findings characteristics of HPOA like bilateral symmetrical increased uptake of the radiopharmaceutical along the cortical margins of the long bones. Read More

    Poorly Differentiated Neuroendocrine Tumor of the Esophagus with Hypertrophic Osteoarthropathy and Brain Metastasis: A Success Story.
    Cureus 2016 Jun 19;8(6):e646. Epub 2016 Jun 19.
    Medicine, Tufts Medical Center.
    Neuroendocrine carcinomas (NECs) of the esophagus are very rare. The majority of the patients with NECs present with metastasis. Paraneoplastic syndromes, such as syndrome of inappropriate secretion of anti-diuretic hormone and watery diarrhea-hypokalemia-achlorhydria syndrome, have been reported in previous reports. Read More

    Digital clubbing: forms, associations and pathophysiology.
    Br J Hosp Med (Lond) 2016 Jul;77(7):403-8
    Consultant Cardiologist in the Department of Cardiology, Hillingdon and Mount Vernon Hospitals NHS Foundation Trust, Middlesex.
    Among proposed mechanisms to explain digital clubbing, the release of cytokines, specifically vascular endothelial growth factor and platelet-derived growth factor, from aggregated platelets and megakaryocytes has emerged as the most likely explanation. This review describes these and other contributory processes. Read More

    [Pulmonary MALT lymphoma and paraneoplastic syndromes].
    Rev Mal Respir 2016 Nov 4;33(9):799-803. Epub 2016 May 4.
    Service de pneumologie, CHU Félix-Guyon, allée des Topazes, 97400 Saint-Denis, Réunion.
    Introduction: Primary pulmonary lymphoma is a rare disease; diagnosis is often delayed because of atypical clinical presentation and slow progression.

    Observation: A 42-year-old woman consulted because of haemoptysis. Chest CT-scan showed multiple nodular calcified masses. Read More

    Identification of the Mutations in the Prostaglandin Transporter Gene, SLCO2A1 and Clinical Characterization in Korean Patients with Pachydermoperiostosis.
    J Korean Med Sci 2016 May 22;31(5):735-42. Epub 2016 Mar 22.
    Department of Internal Medicine, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea .
    Pachydermoperiostosis (PDP), or primary hypertrophic osteoarthropathy, is a rare genetic disease affecting both skin and bones. Both autosomal dominant with incomplete penetrance and recessive inheritance of PDP have been previously confirmed. Recently, hydroxyprostaglandin dehydrogenase (HPGD) and solute carrier organic anion transporter family member 2A1 (SLCO2A1) were reported as pathogenic genes responsible for PDP. Read More

    Inaccurate pulse CO-oximetry of carboxyhemoglobin due to digital clubbing: case report.
    Undersea Hyperb Med 2016 Jan-Feb;43(1):59-61
    Newer pulse CO-oximeters provide a non-invasive and quick means of measuring oxyhemoglobin, carboxyhemoglobin and methemoglobin. Clubbing has been reported to cause inaccuracy in pulse oximeters. We present a case of inaccurate carboxy-hemoglobin measurement by pulse CO-oximetry due to digital clubbing. Read More

    Primary hypertrophic osteoarthropathy: ultrasound and MRI findings.
    Pediatr Radiol 2016 May 3;46(5):727-30. Epub 2016 Mar 3.
    Clarendon Wing Radiology Department, Leeds Children's Hospital at The Leeds General Infirmary, Belmont Grove, Leeds, West Yorkshire, UK, LS2 9NS.
    Primary hypertrophic osteoarthropathy is a rare genetic disorder related to failures in prostaglandin metabolism. Patients present with joint pain, limb enlargement, skin thickening and finger clubbing. Radiographs show characteristic periosteal reaction and thickening along the long bones. Read More

    Successful treatment of pachydermoperiostosis with etoricoxib in a patient with a homozygous splice-site mutation in the SLCO2A1 gene.
    Br J Dermatol 2016 Feb 15. Epub 2016 Feb 15.
    Department of Dermatology, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China.
    Pachydermoperiostosis (PDP), also named primary hypertrophic osteoarthropathy (PHO: MIM 167100), is a rare genetic disease characterized by 3 major symptoms: pachydermia including cutis verticis gyrata (CVG), periostosis, and digital clubbing. Additional clinical signs and symptoms include seborrheic hyperplasia, hyperhidrosis, and arthropathy. This article is protected by copyright. Read More

    Hypertrophic Osteoarthropathy and Follicular Thyroid Cancer: A Rare Paraneoplastic Syndrome.
    Eur Thyroid J 2015 Dec 14;4(4):266-70. Epub 2015 Aug 14.
    Unité Thyroïde Tumeurs Endocrines, Groupe Hospitalier et Faculté de Médecine Pitié-Salpêtrière, Institut du Cancer, Université Pierre et Marie Curie, Paris, France.
    Background: Hypertrophic osteoarthropathy (HOA) is a rare condition characterized by bone and joint pain and digital clubbing usually associated with bronchopulmonary diseases. Primary HOA is rare and the pathogenesis remains unclear.

    Objectives: Cases of HOA as a paraneoplastic syndrome associated with thyroid carcinoma are very rare - only 2 cases have been described in the literature. Read More

    [Progress in genetic research on pachydermoperiostosis].
    Zhonghua Yi Xue Yi Chuan Xue Za Zhi 2016 Feb;33(1):105-7
    State Key Laboratory of Medical Genetics, School of Life Science, Central South University, Changsha, Hunan 410013, China.
    Pachydermoperiostosis is a rare genetic disease characterized by finger clubbing, periostosis, cutis verticis gyrata and pachydermia accompanied by acroosteolysis and hyperhidrosis. Recently, two susceptibility genes, HPGD and SLCO2A1, have been identified, whose protein products are involved in the transportation of prostaglandin and metabolism underlying pachydermoperiostosis. Here the genetic basis of pachydermoperiostosis and its correlation with its clinical phenotype are reviewed, which may provide a reference for basic research and clinic diagnosis for the disease. Read More

    Cyclooxygenase-2 Expression in Non-Small Cell Lung Cancer Correlates With Hypertrophic Osteoarthropathy.
    Ann Thorac Surg 2016 Feb;101(2):e51-3
    Centre Hospitalier Universitaire Vaudois, Département de Chirurgie Thoracique, Lausanne, Switzerland. Electronic address:
    Hypertrophic osteoarthrpathy (HO) is a rare paraneoplasic syndrome associated with non-small cell lung cancer (NSCLC). The pathophysiology of HO is unknown but was recently related to enhanced levels of urine prostaglandin E2 (PGE2). Here, we report the case of a patient that presented HO in association with a resectable left upper lobe NSCLC. Read More

    Pachydermoperiostosis, a unique entity with distinctive clinical features.
    Dermatol Online J 2015 May 18;21(5). Epub 2015 May 18.
    National Institute of Health Sciences and Nutrition, Salvador Zubirán, Mexico City, Mexico.
    Pachydermoperiostosis, which occurs more frequently in men, is a rare entity with distinctive clinical features and an insidious onset.. We report the case of a 30-year-old man with a one-year history of acropachy, arthralgias, hiperhidrosis, and progressive skin thickening of the face and scalp. Read More

    Pachydermoperiostosis and bladder cancer.
    Dermatol Online J 2015 Jun 16;21(6). Epub 2015 Jun 16.
    San Camillo Hospital, Italy.
    Pachydermoperiostosis or the Touraine-Soulente-Golé syndrome is a rare monogenetic disorder characterized by pachydermia, periostosis and digital clubbing accounts for approximately 3∼5% of all patients with hypertrophic osteoarthropathy. Missense mutations in SLCO2A1 and HPGD genes could plausibly underlie the pathogenesis of pachydermoperiostosis. Patients have usually a favorable outcome with very few cases associated with cancer. Read More

    A Common Mutation and a Novel Mutation in the HPGD Gene in Nine Patients with Primary Hypertrophic Osteoarthropathy.
    Calcif Tissue Int 2015 Oct 2;97(4):336-42. Epub 2015 Jul 2.
    Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Shuaifuyuan No. 1, Dongcheng District, Beijing, 100730, China.
    Primary hypertrophic osteoarthropathy (PHO) is a hereditary bone disease characterized by digital clubbing, periostosis, and pachydermia. The HPGD gene encoding 15-prostaglandin dehydrogenase and SLCO2A1 encoding one type of prostaglandin transporter were found to be responsible for PHO. Mutations of either gene would lead to increased level of prostaglandin E2 (PGE2), which might contribute to the constellation of the symptoms. Read More

    Pathological characterization of pachydermia in pachydermoperiostosis.
    J Dermatol 2015 Jul 11;42(7):710-4. Epub 2015 May 11.
    Department of Dermatology, Toho University School of Medicine, Tokyo, Japan.
    Pachydermoperiostosis is a rare hereditary disease, which presents with the cutaneous manifestations of pachydermia and cutis verticis gyrata. Histological findings in pachydermia frequently include dermal edema, mucin deposition, elastic fiber degeneration, dermal fibrosis and adnexal hyperplasia. However, the severity of these findings varies between clinical reports, and a systematic multiple-case clinicopathological correlative analysis has not been performed to date. Read More

    [Genetic diagnosis for a Chinese Han family with primary hypertrophic osteoarthropathy].
    Zhonghua Yi Xue Yi Chuan Xue Za Zhi 2015 Apr;32(2):213-7
    Department of Endocrinology, Huashan Hospital, Fudan University, Shanghai 200040, P.R. China.
    Objective: To identify the genetic cause for a Chinese Han family affected with primary hypertrophic osteoarthropathy.

    Methods: Whole blood and urine samples were collected from a patient and 7 unaffected relatives of the family. The coding sequences and intron/exon boundaries of HPGD and SLCO2A1 genes of the patient were amplified with polymerase chain reaction and sequenced. Read More

    Primary hypertrophic osteoarthropathy with myelofibrosis and anemia: a case report and review of literature.
    Int J Clin Exp Med 2015 15;8(1):1467-71. Epub 2015 Jan 15.
    Department of Endocrinology and Metabolism, West China Hospital, Sichuan University Chengdu, Sichuan, China.
    Primary hypertrophic osteoarthropathy (PHO) is a rare and usually benign disorder of bone and connective tissue growth. Here we present a 28-year-old male patient presenting to our hospital with PHO and symptomatic anemia. Bone marrow biopsy suggested myelofibrosis, a serious complication of PHO, which is often neglected upon admission, but may lead to life-threatening anemia. Read More

    Rev Bras Reumatol 2014 Dec 23. Epub 2014 Dec 23.
    Departamento de Medicina Física e Reabilitação da Faculdade de Medicina da Universidade Cukurova, Adana, Turquia.
    Hypertrophic osteoarthropathy (HOA) is a condition characterized by arthralgia/arthritis, clubbing, and periosteal reaction. Primary form of HOA is observed at early ages of life and is hereditary in nature. Secondary HOA is more frequently seen in clinical setting and occurs as a result of various disorders including inflammatory and malignant diseases. Read More

    Touraine-Solente-Gole syndrome in two siblings.
    J Coll Physicians Surg Pak 2014 Nov;24 Suppl 3:S247-9
    Department of Paediatric Medicine, Children's Hospital and Institute of Child Health, Lahore.
    Hypertrophic Osteoarthropathy secondary to various causes is not a common entity but primary hypertrophic osteoarthropathy (also called Touraine-Solente-Gole Syndrome) is an extremely rare genetic disorder. It was first described in 1868 by Friedrich and has premier features of clubbing, periostosis and pachydermia. Based on clinical manifestations Touraine Solente and Gole distinguished it into three forms as complete, incomplete and fruste form. Read More

    Pachydermoperiostosis: aesthetic treatment of prematurely aging face with facelift and botulinum toxin a.
    J Craniofac Surg 2014 Nov;25(6):e563-4
    From the Department of Plastic, Reconstructive and Aesthetic Surgery, Yeditepe Medical School, Yeditepe University.
    Pachydermoperiostosis is a rare syndrome that hinders patients' quality of life thru its aesthetics manifestations and functional obstacles. Many techniques for addressing and correcting aesthetic defects associated with pachydermoperiostosis have been introduced, including facelift surgery. This case presentation includes treatment of facial pachydermoperiostosis and restoration of facial aesthetics via treatment with facelift, skin muscle excision, and botulinum toxin A. Read More

    Bilateral ptosis as a presenting feature of primary hypertrophic osteoarthropathy (pachydermoperiostosis): a case report.
    Reumatismo 2014 Nov 6;66(3):249-53. Epub 2014 Nov 6.
    Department of Internal Medicine, Hedi Chaker Hospital, Sfax.
    Pachydermoperiostosis is a rare hereditary disorder, which affects both bones and skin. It is characterized by a combination of dermatologic changes (pachydermia or thickening of the skin) and rheumatologic manifestations (periostosis and finger clubbing). Eyelid ptosis which is caused by thickened eyelids (blepharoptosis) is a less common symptom. Read More

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