A 35-year-old man presented to us with pain and fissuring in his left fifth toe []. The patient noted a groove occurring in the inner aspect of his toe 5 years back, which gradually increased. Similar grooves started appearing in his fourth toe bilaterally since the past 2 years. At the age of 8 years, he had a similar problem affecting the right fifth toe, which gradually led to the loss of the digit as accounted by his father. On examining the father who accompanied him, it was noted that he also had similar but asymptomatic grooving involving the right fourth and fifth toes and left fifth toe []. The grooving was most severe in the fourth toe. The patient presented with hope to control the disease from spreading to all his digits and to prevent any further loss of his digits.\nThe patients were otherwise healthy; all his baseline investigations were done and X-ray of the foot was taken. Antibiotics were given for control of secondary infection and he was advised to prevent trauma to the foot. After control of infection, the patient was referred to plastic surgery for favor of Z plasty procedure. The patient came for regular reviews. On subsequent visits, the patient noted significant reduction in the pain following the procedure with reduction in the progression of the fissuring. The improvement was better for the son than for the father after both underwent Z plasty [Figures and ].
A 52-year-old healthy woman, sought assistance for thickened palms and soles which began\nin her childhood, as well as changes in one of her toes, which began a few years ago.\nShe was the third of five generations involved. Her mother had a finger amputated due to\nthe evolution of the same disease. Physical examination detected transgredient, diffuse\npalmoplantar hyperkeratosis, with constrictive bands on the fifth toe (left)\n(pseudo-ainhum) - generalized ichthyosiform dermatosis with no hearing loss (, \nand ). Anatomopathological examination of the\npalmar region found hyperkeratosis with orthokeratosis and parakeratosis ().