Abstract

LEAO, Inês Torrinha; KIESSLING, Daniel  and  FERREIRA, Fabíola. The ulcerative and mutilating variant of carpal tunnel syndrome: a case report. Rev Port Med Geral Fam [online]. 2020, vol.36, n.3, pp.316-320. ISSN 2182-5173.  https://doi.org/10.32385/rpmgf.v36i3.12550.

Introduction: Carpal tunnel syndrome (CTS) is the most common compressive focal mononeuropathy in clinical practice. In some cases, the clinical presentation may be atypical and in advanced stages, a variety of cutaneous manifestations may occur. Case summary: 84-year-old male patient from an extended middle-class family with a history of hypertension, dyslipidemia, prostate cancer, and bilateral CTS surgery. The patient was observed by his family physician because of partial avulsion of the nail on the third finger of the left hand. He had previously an erosive, painless, apparently non-traumatic, bleeding lesion on the nail bed of that finger with three months of evolution. Considering the suspicion of melanoma, the patient was referred to a dermatology specialist. Meanwhile, due to the presence of recurrent inflammatory signs, he underwent several cycles of antibiotic therapy and surgical debridement. Subsequently, in consultation with dermatology, the biopsy performed excluded the diagnostic suspicion of neoplasia, and the hypothesis of an ulcer-mutilating STC was placed and confirmed by electromyography and suggestive clinic. Commentary: Ulcerative and mutilating CTS are a rare variant of a very common disease in Primary Care. Thus, the family physician should be alert to its existence, initiating the diagnostic approach, ensuring the necessary articulation with the different hospital specialties, and the continuity of care and prevention of complications.

Keywords : Carpal tunnel syndrome; Acro-osteolysis; Skin ulcer.

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