Ainhum, also known as dactylolysis spontanea, is an idiopathic development of a fibrotic constricting band in a digit, most commonly affecting the fifth toe. Pseudoainhum refers to the same phenomenon when associated with other conditions, both hereditary and nonhereditary, such as systemic sclerosis (SSc)1,2,3,4.
A 54-year-old woman with a previous history of ovarian adenocarcinoma presented with painful edema of the distal half of the fifth left finger. Physical examination revealed 3 digital constricting bands, the strongest located on the second phalange of the fifth left finger. On both hands, cutaneous SSc of the distal half of the fingers was present (Figure 1 and Figure 2). Over the last 30 years, she had complaints suggesting Raynaud phenomenon (RP) with occasional digital ulcerations. Further investigation revealed mixed connective tissue disease with severe RP. The above-mentioned annular constrictions were interpreted as pseudoainhum. Iloprost was started, with resolution of the inflammation of the fingers and improvement of RP. Sustained stabilization of the fibrotic constrictive pseudoainhum over a 3-year followup period was observed.
Left hand with cutaneous sclerosis of the distal half of the fingers.
Right hand with cutaneous sclerosis and pseudoainhum of the fifth finger.
