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Keratoderma with pseudo-Quincke's pulse

S A Norton1

  • 1Dermatology Service, Raymond Bliss Army Health Clinic, Fort Huachuca, Arizona 85613, USA.

Cutis
|October 14, 1998
PubMed
Summary
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Quincke's capillary pulse, a sign of arterial pulsations, can be mimicked by physical compression. In a patient with sclerodactyly, nailbed pulsations were caused by tissue compression, not hemodynamic changes.

Area of Science:

  • Cardiology
  • Dermatology
  • Vascular Biology

Background:

  • Quincke's capillary pulse is a physical examination sign indicating arterial pulsations in the nailbed.
  • It is typically observed in individuals with widened pulse pressures, such as those with aortic insufficiency.
  • The sign involves alternating red and white flashes upon light pressure on the fingernail's distal edge.

Observation:

  • A case report details a patient presenting with keratoderma and sclerodactyly.
  • This patient's fingernails displayed rapid color changes that mimicked Quincke's capillary pulse.
  • The observed pulsations were visually similar to true arterial pulsations.

Findings:

  • The rapid color changes in the patient's fingernails were attributed to sclerodactylous compression of the nailbeds.

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  • This compression altered blood flow dynamics within the nailbed vasculature.
  • The pulsations were not indicative of a primary hemodynamic process or condition like aortic insufficiency.

    • Implications:

    • This case highlights the importance of differentiating true Quincke's pulse from artifactual pulsations caused by external compression.
    • Understanding the underlying mechanism is crucial for accurate diagnosis in patients with connective tissue disorders affecting the digits.
    • Distinguishing between hemodynamic and mechanical causes of nailbed pulsations can prevent misdiagnosis of cardiovascular conditions.