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Chronic Pustular Eruption of the Thumbs
Joseph Yerushalmi, MD;
Marcelo H. Grunwald, MD;
Dafna Hallel-Halevy, MD;
Ilana Avinoach, MD, PhD;
Sima Halevy, MD
Soroka University Medical Center, Beer-Sheva, Israel
Arch Dermatol. 2000;136:925-930.
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| Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings. |
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REPORT OF A CASE
A 47-year-old woman presented with a 23-year history of a symmetrical eruption on both thumbs. There was no family or personal history of skin diseases. The eruption started in the fingernail region and spread proximally over the years. Physical examination revealed dystrophic fingernails and symmetrical erythematous, pustular, and scaly plaques covering both thumbs (Figure 1 and Figure 2). Movement of both thumbs was limited. The results of the rest of the physical examination and routine laboratory tests were unremarkable. Fungal cultures from the patient's fingernails and fungal and bacterial cultures from pustules were all negative. A punch biopsy specimen was obtained from a pustule (Figure 3).
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Figure 1.
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Figure 2.
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Figure 3.
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What is your diagnosis?
Diagnosis: Acrodermatitis continua of Hallopeau (ACH).
Microscopic examination of the biopsy specimen showed hyperkeratosis, mild parakeratosis, acanthosis, and elongation . . . [Full Text of this Article]
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