Generic selectors
Exact matches only
Search in title
Search in content
Search in posts
Search in pages
Filter by Categories
15th National Conference of the IAOMFP, Chennai, 2006
Abstract
Abstracts from current literature
Acne in India: Guidelines for management - IAA Consensus Document
Addendum
Announcement
Art & Psychiatry
Article
Articles
Association Activities
Association Notes
Award Article
Book Review
Brief Report
Case Analysis
Case Letter
Case Letters
Case Notes
Case Report
Case Reports
Clinical and Laboratory Investigations
Clinical Article
Clinical Studies
Clinical Study
Commentary
Conference Oration
Conference Summary
Continuing Medical Education
Correspondence
Corrigendum
Cosmetic Dermatology
Cosmetology
Current Best Evidence
Current View
Derma Quest
Dermato Surgery
Dermatopathology
Dermatosurgery Specials
Dispensing Pearl
Do you know?
Drug Dialogues
e-IJDVL
Editor Speaks
Editorial
Editorial Remarks
Editorial Report
Editorial Report - 2007
Editorial report for 2004-2005
Errata
Erratum
Focus
Fourth All India Conference Programme
From Our Book Shelf
From the Desk of Chief Editor
General
Get Set for Net
Get set for the net
Guest Article
Guest Editorial
History
How I Manage?
IADVL Announcement
IADVL Announcements
IJDVL Awards
IJDVL AWARDS 2015
IJDVL Awards 2018
IJDVL Awards 2019
IJDVL Awards 2020
IJDVL International Awards 2018
Images in Clinical Practice
In Memorium
Inaugural Address
Index
Knowledge From World Contemporaries
Leprosy Section
Letter in Response to Previous Publication
Letter to Editor
Letter to the Editor
Letter to the Editor - Case Letter
Letter to the Editor - Letter in Response to Published Article
LETTER TO THE EDITOR - LETTERS IN RESPONSE TO PUBLISHED ARTICLES
Letter to the Editor - Observation Letter
Letter to the Editor - Study Letter
Letter to the Editor - Therapy Letter
Letter to the Editor: Articles in Response to Previously Published Articles
Letters in Response to Previous Publication
Letters to the Editor
Letters to the Editor - Letter in Response to Previously Published Articles
Letters to the Editor: Case Letters
Letters to the Editor: Letters in Response to Previously Published Articles
Medicolegal Window
Messages
Miscellaneous Letter
Musings
Net Case
Net case report
Net Image
Net Letter
Net Quiz
Net Study
New Preparations
News
News & Views
Obituary
Observation Letter
Observation Letters
Oration
Original Article
ORIGINAL CONTRIBUTION
Original Contributions
Pattern of Skin Diseases
Pearls
Pediatric Dermatology
Pediatric Rounds
Perspective
Presedential Address
Presidential Address
Presidents Remarks
Quiz
Recommendations
Regret
Report
Report of chief editor
Report of Hon : Treasurer IADVL
Report of Hon. General Secretary IADVL
Research Methdology
Research Methodology
Resident page
Resident's Page
Resident’s Page
Residents' Corner
Residents' Corner
Residents' Page
Retraction
Review
Review Article
Review Articles
Revision Corner
Self Assessment Programme
SEMINAR
Seminar: Chronic Arsenicosis in India
Seminar: HIV Infection
Short Communication
Short Communications
Short Report
Special Article
Specialty Interface
Studies
Study Letter
Supplement-Photoprotection
Supplement-Psoriasis
Symposium - Contact Dermatitis
Symposium - Lasers
Symposium - Pediatric Dermatoses
Symposium - Psoriasis
Symposium - Vesicobullous Disorders
SYMPOSIUM - VITILIGO
Symposium Aesthetic Surgery
Symposium Dermatopathology
Symposium-Hair Disorders
Symposium-Nails Part I
Symposium-Nails-Part II
Tables
Technology
Therapeutic Guidelines
Therapeutic Guidelines - IADVL
Therapeutics
Therapy
Therapy Letter
View Point
Viewpoint
What’s new in Dermatology
Letter To Editor
2003:69:4;309-310
PMID: 17642924

Nail involvement in degenerative collagenous plaques of the hands

B Jeevankumar1 , DM Thappa1 , S Jayanthi2
1 Departments of Dermatology, Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry - 605006, India
2 Departments of Pathology, Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry - 605006, India

Correspondence Address:
D M Thappa
Departments of Dermatology and STD, JIPMER, Pondicherry - 605006
India
How to cite this article:
Jeevankumar B, Thappa D M, Jayanthi S. Nail involvement in degenerative collagenous plaques of the hands . Indian J Dermatol Venereol Leprol 2003;69:309-310
Copyright: (C)2003 Indian Journal of Dermatology, Venereology, and Leprology

Sir,

Degenerative collagenous plaques of the hands is a rare variant of marginal papular acrokeratodermas.[1] The lesions are usually seen as linear bands principally around the web of the thumb and index finger at the margin of the volar and dorsal surfaces.[2] We report a unique case where the thumbnails were also involved.

A 65-year-old male agricultural laborer presented with a one year history of asymptomatic nicking of both the thumbnails. He had also noticed asymptomatic skin lesions on the sides of the index fingers and thumbs. He had no history of Raynaud′s phenomenon. He was a farmer and was involved in hard manual labor. No family member had a similar disorder.

Physical examination revealed skin-colored to yellowish-white, firm, waxy papules and plaques, bilaterally symmetrically distributed along the margins of the thumb and index fingers, ulnar sides of the hands, and middle and ring fingers. The same lesions were seen extending to the nail bed via the hyponychium, producing V-shaped nicking of nail plate of the thumbs on both sides [Figure - 1]. The soles were normal. Systemic examination was unremarkable.

Routine hematological and biochemical investigations were within normal limits. Nail clippings were negative for fungi. Histological examination of two fragments of the lesional tissue, one from the radial margin of the index finger and the other from the thumb nail bed [Figure - 2], revealed hyperkeratosis and acanthosis. The dermis showed dense collagen bundles arranged in a haphazard fashion, some running perpendicular to the surface from the papillary dermis to the deep dermis. Staining with Verhoeff-van Gieson stain revealed degeneration of collagen and elastic fibres. These features were consistent with the diagnosis of degenerative collagenous plaques of the hands.

The term ′degenerative collagenous plaques of the hands refers to a rare acquired skin disorder localized to the hands.[3] It mainly affects elderly individuals exposed to chronic sun exposure and trauma to the hands.[4] It has been described in Indian housewives, in whom household trauma has been incriminated as the precipitating factor.[5],[6] These lesions morphologically resemble those of acrokeratoelastoidosis, but there is no involvement of the feet and no familial predisposition.[7],[8] In a fully developed case, both hands are symmetrically involved. The lesions are wrinkled or depressed, scaly or smooth, yellowish waxy papules, which may coalesce to form band-like firm linear plaques that extend from near the base of the thumb around the web distally to the side of the index finger at the junction of the palmar and dorsal skin. The ulnar sides of the hands, and less commonly the medial and lateral sides of the middle and ring fingers, may be involved in a similar fashion.[3] Histologically, a distinctive deposition of dense collagen and degenerated elastic fibers in the reticular dermis is seen.[8] Because of different pathogenic interpretations, this entity has also been reported as limiting or marginal keratodermas of the palms, keratoelastoidosis marginalis of the hands, marginal collagen degeneration, and digital papular calcific elastosis.

The exact pathogenesis of this condition is unknown, but probably a combination of long-term trauma and pressure together with some degree of actinic damage is responsible for the localization of lesions in these sites.[9] In our case, these factors have not only produced lesions on the border of the fingers and palms, but also the thumbnail beds, leading to V-shaped nicking of the nails. To the best of our knowledge, such a nail change in association with this disorder has not been described earlier.

References
1.
Rongioletti F, Betti R, Crosti C, Rebora A. Marginal papular acrokeratodermas: a unified nosography for focal acral hyperkeratosis, acrokeratosis, acrokeratoelastoidosis and related disorders. Dermatology 1994;88:28-31.
[Google Scholar]
2.
Griffiths WAD, Judge MR, Leigh IM. Disorders of keratinization. In: Champion RH, Burton JL, Burns DA, Breathnach SM, editors. Textbook of dermatology. 6th ed. Oxford: Blackwell Science; 1998. p. 1483-588.
[Google Scholar]
3.
Burks JW, Wise LJ, Clark WH. Degenerative collagenous plaques of the hands. Arch Dermatol 1960;82:362-6.
[Google Scholar]
4.
Ritchie EB, Williams HM Jr. Degenerative collagenous plaques of the hands. Arch Dermatol 1966;93:202-3.
[Google Scholar]
5.
Sehgal VN, Singh M, Korrane RV, Nayyar M, Chandra M. Degenerative collagenous plaque of the hand (linear keratoelastoidosis of the hands). A variant of acrokeratoelastosis. Dermatologica 1980;161:200-4.
[Google Scholar]
6.
Mittal R, Chopra A, Gupta K. Degenerative collagenous plaques of the hands. Indian J Dermatol 1984;29:47-51.
[Google Scholar]
7.
Johnson B Jr, Honig P. Congenital diseases (Genodermatoses). In: Elder D, Elenitsas R, Jaworsky C, Johnson B Jr, editors. Histopathology of the skin. 8th ed. Philadelphia: Lippincott-Raven; 1997. p. 117-50.
[Google Scholar]
8.
Abulafia J, Vignale RA. Degenerative collagenous plaques of the hands and acrokeratoelastoidosis: pathogenesis and relationship with knuckle pads. Int J Dermatol 2000;39:424-32.
[Google Scholar]
9.
Mehregan AH. Degenerative collagenous plaques of the hands. Arch Dermatol 1966;93:633.
[Google Scholar]
Show Sections