Pachydermoperiostosis (idiopathic hypertrophic osteoarthropathy)--a case report and review

We report a Chinese patient with the complete form of pachydermoperiostosis. He presented with typical features consisting of palmoplantar hyperhidrosis, clubbing with spade-like enlargement of the hands and feet, cutis verticis gyrata, thickening and furrowing of the facial and forehead skin, and irregular thickening of the cortical bone with subperiosteal new bone formation involving the radii, ulnae. tibiae and fibulae. Classically, pachydermoperiostosis is characterised by a triad of finger clubbing, periosteal new bone formation, skin and soft tissue changes, giving an acromaegaloid look. Although rare, it is important to recognise this condition as misdiagnosis may subject the patient to unnecessary investigations and worry. The typical features and the self-limiting nature of this entity are emphasised.