Eur J Med Genet 2017 Aug 8;60(8):433-436. Epub 2017 Jun 8.

Department of Endocrinology, The First Central Hospital(BDCH), Baoding 071000, China. Electronic address:

We report on a rare case of pachydermoperiostosis (PDP) in a 25-year-old male who was admitted to our hospital because of enlargement of fingers and toes. Through examination, we found some typical features on the patient including finger clubbing, periostosis, pachydermia, and cutis verticis gyrata (CVG). But laboratory tests were almost within normal ranges, which ruled out rheumatic arthritis, osteopulmonary arthropathy, thyroid acropathy, and acromegaly. Read More

Endocrinol Diabetes Metab Case Rep 2017 16;2017. Epub 2017 May 16.

Endocrinology Unit, Department of Medicine, Putrajaya Hospital, PutrajayaMalaysia.

Pachydermoperiostosis is a very rare osteoarthrodermopathic disorder whose clinical and radiographic presentations may mimic those of acromegaly. In the evaluation of patients with acromegaloid appearances, pachydermoperiostosis should be considered as a differential diagnosis. In this article, we report a 17-year-old boy who presented with 2-year history of acral enlargement and facial appearance changes associated with joint pain and excessive sweating. Read More

Endocrinol Diabetes Metab Case Rep 2017 19;2017. Epub 2017 Apr 19.

Department of Endocrinology, Centre Hospitalier Universitaire de Liège, University of Liège, LiègeBelgium.

Summary: A 20-year-old man with an 8-year history of progressive enlargement of his hands and feet, coarsening facial features, painful joints and thickened, oily skin was referred for investigation of acromegaly. On examination, the subject was of normal height and weight. He had markedly increased skin thickness around the forehead, eyelids and scalp with redundant skin folds. Read More

J Bone Miner Res 2017 Apr 20. Epub 2017 Apr 20.

Metabolic Bone Disease and Genetics Research Unit, Department of Osteoporosis and Bone Diseases, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.

Primary hypertrophic osteoarthropathy (PHO) is a rare inherited disease caused by genetic defects in the prostaglandin metabolism pathway; disturbed prostaglandin E2 (PGE2 ) catabolism resulting in increased PGE2 level is suggested in the pathogenesis. Forty-three Han Chinese patients with PHO were studied and 41 of them were treated. Mutations in the HPGD gene, causing hypertrophic osteoarthropathy, primary, autosomal recessive 1 (PHOAR1; OMIM 259100), were identified in seven patients, and mutations in the SLCO2A1 gene, causing hypertrophic osteoarthropathy, primary, autosomal recessive 2 (PHOAR2; OMIM 614441), were identified in 36 patients. Read More

Mol Med Rep 2017 May 24;15(5):2977-2982. Epub 2017 Mar 24.

Department of Respiratory Medicine, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, P.R. China.

Primary hypertrophic osteoarthropathy (PHO), which is a rare multi‑organic disease characterized by digital clubbing, pachydermia and periosteal reaction, typically begins during childhood or adolescence and progresses gradually over years prior to disease stabilization. To date, only two genes have been reported to be associated with PHO, 15‑hydroxyprostaglandin dehydrogenase and solute carrier organic anion transporter family, member 2A1 (SLCO2A1). However, the pathogenesis and the functions of the underlying genes remain to be fully elucidated. Read More

Pan Afr Med J 2016 25;25:194. Epub 2016 Nov 25.

Department of Orthopaedics, Sahloul Hospital, Faculty of Medicine of Sousse, Sousse, Tunisia.

Zhonghua Nei Ke Za Zhi 2017 Mar;56(3):194-198

Department of Endocrinology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China.

Objective: To analyze the clinical and genetic features of primary hypertrophic osteoarthropathy (PHO). Methods: The clinical data of one Chinese pedigree of PHO, namely pachydermoperiostosis (PDP) were collected.Blood samples were drawn from the propositus and other family members. Read More

Acta Derm Venereol 2017 06;97(6):761-762

Department of Dermatology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.

J Dermatol 2017 Feb 13. Epub 2017 Feb 13.

Department of Dermatology, Toho University School of Medicine, Tokyo, Japan.

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

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

J Dermatol 2016 Dec 27. Epub 2016 Dec 27.

Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan.

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

Ophthal Plast Reconstr Surg 2017 Jul/Aug;33(4):e92-e94

*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

Joint Bone Spine 2017 Jul 21;84(4):509-510. Epub 2016 Oct 21.

Paris Descartes University, Sorbonne Paris Cité, 75006 Paris, France; Rheumatology A Department, Cochin Hospital, APHP, 75014 Paris, France. Electronic address:

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

Indian J Endocrinol Metab 2016 Sep-Oct;20(5):730-731

Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India.

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

Br J Hosp Med (Lond) 2016 Sep;77(9):544

Honorary Consultant Physician Respiratory Support and Sleep Centre Papworth Hospital Papworth Hospital NHS Foundation Trust Cambridge CB23 3RE.

Tunis Med 2016 Feb;94(2):152-5

Pachydermoperiostosis or primary hypertrophic osteoarthropathy is a rare disorder with autosomal inheritance. It is characterized by finger clubbing, periostosis and sometimes skin changes as pachydermia. It occurs more commnly in young and male subjects. Read More

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

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

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

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

Acta Clin Belg 2016 Jun 22;71(3):123-30. Epub 2016 Apr 22.

c Department of General Internal Medicine , University Hospital Leuven , Belgium.

Background: Digital clubbing and hypertrophic osteoarthropathy (HOA) form a diagnostic challenge. Subtle presentations of clubbing are often missed. The underlying pathophysiology remains unclear. Read More

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

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

BMJ Case Rep 2016 Feb 17;2016. Epub 2016 Feb 17.

Department of Endocrinology & Metabolism, Institute of Postgraduate Medical Education and Research/SSKM Hospital, Kolkata, West Bengal, India.

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

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

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

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

Indian J Dermatol Venereol Leprol 2016 Jan-Feb;82(1):57-8

Department of Dermatology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.

J Rheumatol 2015 Nov;42(11):2211-4

Department of Pediatric Immunology, UMC.

Circulation 2015 Sep;132(13):e157-9

From Departments of Cardiology (S.K.S, D.A., A.S., K.C., M.K.S., K.B.) and Radio-Diagnosis (K.G.), RNT Medical College, Udaipur, India.

Dtsch Med Wochenschr 2015 Sep 11;140(18):1345, 1393. Epub 2015 Sep 11.

Klinik III für Innere Medizin, Universität zu Köln.

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

Med J Armed Forces India 2015 Jul 3;71(Suppl 1):S187-9. Epub 2014 Apr 3.

Classified Specialist (Medicine), Command Hospital (Southern Command), Pune 411040, India.

Joint Bone Spine 2016 Jan 14;83(1):113-4. Epub 2015 Jul 14.

Chair of Rheumatology and Rheumatology Unit, University Clinic AOU of Cagliari, SS 554, 09042 Monserrato, Cagliari, Italy.

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

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

J Dermatol 2015 Sep 13;42(9):908-10. Epub 2015 Jun 13.

Department of Dermatology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.

MMW Fortschr Med 2015 May;157(10):34

, .

JAAPA 2015 Jun;28(6):65-6

Narisha Ali practices at Memorial Sloan Kettering Cancer Center in New York City and Long Island Jewish Medical Center in New Hyde Park, N.Y. The author has disclosed no potential conflicts of interest, financial or otherwise.

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

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

Rev Prat 2015 Jan;65(1):26-7

J Dermatol 2015 06 21;42(6):655-7. Epub 2015 Mar 21.

Department of Dermatology, Yonsei University College of Medicine, Seoul, Korea.

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

J Dermatol Sci 2015 May 11;78(2):153-5. Epub 2015 Feb 11.

Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan.