Large Nonosseous Preaxial Polydactyly: Unique Case With Vascular Proliferation and Subepidermal Bullae

Area of Science:

• Hand surgery
• Congenital anomalies
• Medical genetics

Background:

• Preaxial polydactyly (PPD) involves extra digits on the thumb side, with diverse presentations.
• Existing classification systems for PPD struggle to categorize all observed phenotypes.
• A rare, nonosseous PPD case is presented that falls outside current classifications.

Purpose of the Study:

• To report a unique case of preaxial polydactyly.
• To discuss the implications of this case for existing PPD classification systems.
• To advocate for the inclusion of this phenotype in future classifications.

Main Methods:

• Clinical presentation and surgical management of a rare PPD case.
• Pathological examination of the excised supernumerary digit.
• Literature review of similar PPD cases.

Main Results:

• Successful surgical excision of a large, nonosseous PPD.
• Pathology revealed a soft-tissue-only digit with vascular proliferation and subepidermal bullae.
• The case did not align with established PPD classification criteria.

Conclusions:

• This rare PPD phenotype necessitates inclusion in existing classification systems.
• Accurate classification aids in patient counseling and clinical decision-making.
• Further research and classification updates are needed for comprehensive PPD management.