Document Type : Case reports


1 Faculty of Medicine, University of Novi Sad, Novi Sad, Republic of Serbia Institute for Children and Youth Health Care of Vojvodina, Novi Sad, Republic of Serbia

2 Faculty of Medicine, University of Novi Sad, Novi Sad, Republic of Serbia

3 State University of Novi Pazar, Department of Psychology, Novi Pazar, Republic of Serbia

4 Health Center, Temerin, Republic of Serbia


Introduction: Pachydermodactyly is a very rare type of macrodactyly. It clinically resembles juvenile rheumatoid arthritis, but it has a non-inflammatory etiology without bone, articular, or synovial involvement.
Case Presentation: In this study, we report the case of a 15-year-old boy with repetitive behavior diagnosed with a pachyder- modactyly after evaluation of bilateral swelling of the proximal interphalangeal joints. Histologic examination revealed epider- mal hyperorthokeratosis, thickening of the dermis with increased dermal collagen and absence of inflammatory cells. Pachyder- modactyly is a very rare condition associated with compulsive behavior and results from repetitive minor trauma that causes local- ized proliferation of fibrous tissue. Conclusions: Pachydermodactyly is a dermatological sign of compulsive behavior and repetitive minor trauma, and it should be
distinguished from other forms of joint enlargement to avoid unnecessary medicamentous treatment. Control examinations did not reveal clinically relevant worsening even without any treatment applied.