Clenched fist syndrome with palmar lichen planus

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dc.contributor.authorAytekin, S
dc.contributor.authorTurhanoglu, AD
dc.contributor.authorOzkan, M
dc.contributor.authorUzunlar, AK
dc.date.accessioned2024-04-24T17:11:30Z
dc.date.available2024-04-24T17:11:30Z
dc.date.issued2005
dc.departmentDicle Üniversitesien_US
dc.description.abstractA 16-year-old girl had a 4-year history of hyperkeratosis and fissures on the palm. The skin lesions had gradually progressed to thick hyperkeratosis with mild pruritus, diffusely covering the right palm, and leading to flexion contractures of the fingers with mild pain. There was no family history of similar lesions. Her father had died 4 years previously. Dermatologic examination revealed hyperkeratosis, scaling, a mild yellow color, fissures, and maceration on the palm and volar surface of the fingers of the right hand ( Fig. 1). There was an approximately 3 cm x 4 cm hyperkeratotic lesion on the palm of the left hand. Flexion contractures were found at the metacarpophalangeal and proximal interphalangeal joints of the three fingers of the right hand ( Fig. 1). There was no pain, tenderness in the joints of the fingers, or palpable nodular lesions on the palmar surface of the hand. Forced extension was difficult, and there was pain with passive extension. Radiography of the patient's hands revealed no abnormality, other than the clenched fingers. Electromyography of the upper extremities was normal. There were no lesions of the oral mucosa. The nails and scalp were normal. The patient showed very poor eye contact, and responded tersely and somewhat reluctantly to questions about her medical history. The patient was evaluated by psychiatry, but did not meet the diagnostic criteria for any mental disorder. There was a schizoid personality characteristic on both the structured clinical interview for DSM-IV personality disorders (SCID-II) and the Minnesota Multiphasic Personality Inventory ( MMPI). In addition, there was an increase in scores on the hostility and resentment/ aggression subscales of the MMPI. The results of routine laboratory tests were within normal limits or negative, including the venereal disease research laboratory ( VDRL) test. A skin biopsy specimen showed histopathologic changes of lichen planus ( orthokeratotic hyperkeratosis, focal hypergranulosis, acanthosis, papillomatosis, and vacuolization with dense lymphocytic reaction at the dermo- epidermal junction) ( Fig. 2). The patient was treated with topical 5% salicylic acid and 0.1% methylprednisolone aceponate ointment. Static splinting plus stretching was used for hand therapy. Active assisted motion was employed. The treatment produced a remarkable reduction in the skin lesions ( Fig. 3), but no improvement in the flexion posture of the hand. The psychiatric and clinical findings were thought to be consistent with clenched fist syndrome and lichen planus.en_US
dc.identifier.doi10.1111/j.1365-4632.2004.02029.x
dc.identifier.endpage242en_US
dc.identifier.issn0011-9059
dc.identifier.issn1365-4632
dc.identifier.issue3en_US
dc.identifier.pmid15807736
dc.identifier.scopus2-s2.0-15844415670
dc.identifier.scopusqualityQ1
dc.identifier.startpage240en_US
dc.identifier.urihttps://doi.org/10.1111/j.1365-4632.2004.02029.x
dc.identifier.urihttps://hdl.handle.net/11468/17569
dc.identifier.volume44en_US
dc.identifier.wosWOS:000227499700015
dc.identifier.wosqualityQ4
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoenen_US
dc.publisherWileyen_US
dc.relation.ispartofInternational Journal of Dermatology
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subject[No Keyword]en_US
dc.titleClenched fist syndrome with palmar lichen planusen_US
dc.titleClenched fist syndrome with palmar lichen planus
dc.typeArticleen_US

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