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Pseudoainhum : A rare disease

PseudoainhumPseudoainhum is a rare and poorly characterised phenomenon involving autoamputation of a digit associated with an identifiable or related disease process.

Ainhum does not have any predisposing condition associated while pseudoainhum is associated with predisposing conditions like trauma, leprosy, scleroderma, and diabetes. Other diseases which can cause pseudoainhum include psoriasis, scleroderma, and Raynaud disease. The constricting bands of pseudoainhum can also occur secondary to scar formation from trauma, burns, and other injuries.

It is thought that histological changes in pseudoainhum resemble those in ainhum, which initially presents with gross thickening of the stratum coreneum, and calcification of the ducts and the sweat glands. At a more advanced stage, there is chronic inflammation below the hyperkeratotic epithelium. As the fissure deepens due to this fibrotic reaction of collagen with a hyperkeratotic epidermis, tendons, vessels and nerves are compressed with eventual absorption of the bone by pressure. The latter stages are generally thought to be sterile and avascular


These photos are of a female patient aged 36 years. She was a known case of traumatic paraplegia and congestive cardiac failure. The disease process was bilateral involving multiple toes.




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