CARPAL TUNNEL SYNDROME - ULCERATIVE AND MUTILATING VARIANT

Abstract

Background: The cutaneous changes related to the carpal tunnel syndrome are rare.

Case report: We describe the case of a 77 years old, male patient who had lesions limited to the sesnsorial area of his left hand’s median nerve. The lesions were ulcerations in the second and third fingers, cutaneous hyperkeratosis, dys- trophic changes in the nails, pus-filled inflammation, shrinkage of the distal phalanxes and acral osteolysis displayed in the hand’s radiography. The patient, who until that time refused the decompressive surgery of the median nerve, was once more redirected to an Orthopaedic consult.

Discussion: Bouvier was the first to describe the ulcerative and mutilating variant of carpal tunnel syndrome, whi- ch includes skin (atrophy, anhidrosis, erythema, swelling, blisters, sclerodactyly, and indolent ulcers), nail and bone changes(acro-osteolysis). Surgical decompression is the definitive treatment for this severe form of the disease, leading to a considerable improvement. However,osteolysisis irreversible.

KEYWORDS – Carpal Tunnel Syndrome; Acral-osteolysis; Nails, Malformed; Skin Ulcer.