We present a case of 38-year-old woman who presented to our Dermatology OPD with complaints of palmoplantar thickening and scaling. During her childhood, she had noticed slight scaling localized to bilateral palms and soles which then progressed to become brownish honeycomb transgradient hyperkeratosis over a period of around ten years (Figure ; Figure ). It was associated with pain, tightening, and winter aggravation. She also had generalized dryness of the skin. However, she did not receive any treatment, and at the age of twenty-five years, she gradually developed a constriction band around the fifth toe which gradually tightened leading to pseudoainhum with amputation at the level of the proximal interphalangeal joint (Figure ). Her hearing, vision, hair, and nails were normal. Among her two children, the elder son is eleven years old and is also affected and the younger daughter is unaffected till this date. Considering the presence of transgradient honeycomb keratoderma with generalized ichthyosis and pseudoainhum in the absence of deafness, a diagnosis of Camisa syndrome was made.
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 ].