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Phalangeal microgeodic syndrome and pine processionary caterpillar.

Véronique Viseux1, Guillaume Chaby, Patrick Esquenet

  • 1Department of Dermatology and Venereology, CHU Sud, 80054 Amiens, France.

European Journal of Dermatology : EJD
|December 25, 2003
PubMed
Summary
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Phalangeal Microgeodic Syndrome (PMS) is a rare condition causing finger swelling and bone lesions. This case links PMS to a child

Area of Science:

  • Pediatric Rheumatology
  • Dermatology
  • Pathology

Background:

  • Phalangeal Microgeodic Syndrome (PMS) is a rare condition characterized by osteolytic lesions in the phalanges.
  • The etiology of PMS remains largely unknown, with previous hypotheses suggesting circulatory disturbances.
  • Differential diagnoses include sickle cell anemia, syphilis, osteomyelitis, tuberculosis, and sarcoidosis.

Observation:

  • An 11-month-old girl presented with a one-month history of edematous fingers.
  • She had a prior history of mucocutaneous reaction to a processionary caterpillar.
  • Radiographs revealed small, round lytic lesions in the phalanges.

Findings:

  • A bone biopsy confirmed fibrosis and foreign bodies resembling caterpillar hairs within an epithelioid granuloma in an osteolytic lesion.

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  • This led to a diagnosis of Phalangeal Microgeodic Syndrome (PMS).
  • The findings suggest a potential link between environmental exposures, specifically caterpillar hairs, and the development of PMS.

    • Implications:

    • This case presents the first documented instance of PMS in a child with a direct history of caterpillar exposure.
    • It highlights the importance of considering environmental factors and specific exposures in the differential diagnosis of pediatric bone lesions.
    • Further research is warranted to elucidate the role of environmental triggers in the pathogenesis of Phalangeal Microgeodic Syndrome.