A 26 year-old man with lion- like face [dermatological face] and drumstick- like fingers [digital clubbing](hypertrophic osteoarthropathy) for 6 years.
X-rays films show thickening of the periosteum of ribs, upper and lower limb bones.
Skin ultrasound with 23 MHz probe reveales thickening of subcutanous layer and skin of forehead # 5mm, neck #1mm, cheek #3 mm. It exists distorted structures as hyperechoic and hypoechoic layers in appearance without vascularisation.
Cheek (L) and neck (R) skin.
Forehead skin # 5 mm of the patient (L) and evidence # 2mm (R).
Skin biopsy result is related to Tourain-Solente-Gole syndrome (pachydermoperiostosis) which is a rare hereditary disorder affecting to bone and skin.
Pachydermoperiostosis (PDP) is a form of primary hypertrophic osteoarthropathy (see this term), a rare hereditary disorder, and is characterized by digital clubbing, pachydermia and subperiosteal new bone formation associated with pain, polyarthritis, cutis verticis gyrata, seborrhea and hyperhidrosis (from Orphanet).
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