Digital Ulcers as Presentation of Carpal Tunnel Syndrome
Abstract
Ulcerating and mutilating variant of carpal tunnel syndrome occurs in longstanding cases of untreated disease. Pa- tients present with painless ulcers of the second and third fingers, accompanied with other cutaneous and sensory changes. These patients are often misdiagnosed as having a Raynaud disease or systemic sclerosis. Clinical assessment is the gold standard for the diagnosis of carpal tunnel syndrome, but hand radiography and electromyography help supporting the diagnosis. The authors present two cases of this ulcerating variant of carpal tunnel syndrome.
Downloads
References
Werner RA, Andary M. Carpal tunnel syndrome: pathophysiology and clinical neurophysiology. Clin Neurophysiol. 2002;113(9):1373-1381. doi:10.1016/S1388-2457(02)00169-4
Padua L, Coraci D, Erra C, et al. Carpal tunnel syndrome: clinical features, diagnosis, and management. Lancet Neurol. 2016;15(12):1273-1284. doi:10.1016/S1474-4422(16)30231-9
Natale M, Spennato P, Bocchetti A, Fratta M, Savarese L, Rotondo M. Ulcerative and mutilating variant of carpal tunnel syndrome. Acta Neurochir (Wien). 2005;147(8):905-908. doi:10.1007/s00701-004-0478-y
Perdan-Pirkmajer K, Praprotnik S, Tomšič M. Digital ulcers as the first manifestation of carpal tunnel syndrome. Rheumatol Int. 2011;31(5):685-686. doi:10.1007/s00296-009-1229-4
Bouvier M, Lejeune E, Rouillat M, Marionnet J. [Disfiguring ulcer forms of the carpal tunnel syndrome]. Rev Rhum Mal Osteoartic. 1979;46(3):169-176.
Aratari E, Regesta G, Rebora A. Carpal Tunnel Syndrome Appearing With Prominent Skin Symptoms. Arch Dermatol. 1984;120(4):517-519. doi:10.1001/archderm.1984.01650400099023
Pereira N, Canelas MM, Vieira R, Figueiredo A. Síndrome do Túnel Cárpico - Variante Ulcero-mutilante. Rev da Soc Port Dermatologia e Venereol. 2011;69(3):467-470.
Ormaechea-Pérez N, Arregui-Murua MA, Zubizarreta-Salvador J, Tuneu-Valls. A. Úlceras digitales indoloras como presentación inusual de síndrome de túnel carpiano bilateral severo. Actas Dermosifiliogr. 2012;103(2):159-160. doi:10.1016/j.ad.2010.11.010
Murphy KA, Morrisonponce D. Anatomy, Shoulder and Upper Limb, Median Nerve. StatPearls. Published 2019. Accessed October 30, 2019. Available from: http://www.ncbi.nlm.nih.gov/pubmed/28846302.
Requena C, Requena L, Blanco S, Alvarez C, Galache C, Rodriguez E. Acral ulcerations and osteolysis, a severe form of the carpal tunnel syndrome. Br J Dermatol. 2004;150(1):166-167. doi:10.1111/j.1365-2133.2004.05701.x
Romeo EL, Previti M, Giandalia A, Russo GT, Cucinotta D. Ulcero-osteolytic lesions in a woman with type 2 diabetes and carpal tunnel syndrome: A case report and literature review. Diabetes Res Clin Pract. 2016;113:204-207. doi:10.1016/j.diabres.2016.01.007
Fritz TM, Burg G, Böni R. Carpal Tunnel Syndrome with Ulcerous Skin Lesions. Dermatology. 2000;201(2):165-167. doi:10.1159/000018464
Khan SK, Saeed I. Acral osteolysis in bilateral compartment syndrome. J Radiol Case Rep. 2008;2(2):3-4. doi:10.3941/jrcr.v2i2.36
Dubbioso R, Nolano M, Mazzarella R, Rivellese AA, Manganelli F. Mutilating fingertip ulcers in uncontrolled type 1 diabetes mellitus. Neurol Sci. 2014;35(1):123-124. doi:10.1007/s10072-013-1510-x
Savoia F, Tengattini V, Valenti L, Gaddoni G, Patrizi A. Unilateral finger tip ulcerations. JDDG J der Dtsch Dermatologischen Gesellschaft. 2013;11(6):561-562. doi:10.1111/ddg.12028
All articles in this journal are Open Access under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).