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Hypertrophic osteoarthropathy, primary, autosomal dominant(PHOAD)

MedGen UID:
382429
Concept ID:
C2674695
Disease or Syndrome
Synonyms: PACHYDERMOPERIOSTOSIS, AUTOSOMAL DOMINANT; PDP, AUTOSOMAL DOMINANT; PHO, AUTOSOMAL DOMINANT; PHOAD
 
Gene (location): SLCO2A1 (3q22.1-22.2)
 
Monarch Initiative: MONDO:0008172
OMIM®: 167100

Definition

Autosomal dominant primary hypertrophic osteoarthropathy (PHOAD) is characterized by 3 major features: digital clubbing, periostosis, and pachydermia. Patients may also experience joint swelling and pain, and some have reported gastrointestinal symptoms, including watery diarrhea. Males are more commonly affected, and more severely affected, than females (Lee et al., 2016; Xu et al., 2021). Touraine et al. (1935) recognized pachydermoperiostosis (PDP) as a familial disorder with 3 presentations or forms: a complete form with periostosis and pachydermia, an incomplete form without pachydermia, and a forme fruste with pachydermia and minimal skeletal changes. Genetic Heterogeneity Autosomal recessive forms of PHO have been reported (see 259100), including PHOAR2E (614441), which is also caused by mutation in the SLCO2A1 gene. Patients with autosomal recessive PHO do not experience gastrointestinal symptoms. [from OMIM]

Clinical features

From HPO
Knee pain
MedGen UID:
65421
Concept ID:
C0231749
Sign or Symptom
An unpleasant sensation characterized by physical discomfort (such as pricking, throbbing, or aching) localized to the knee.
Elevated urinary prostaglandin E2 level
MedGen UID:
411843
Concept ID:
C2749457
Finding
An increased amount of prostaglandin E2 in the urine.
Clubbing of fingers
MedGen UID:
3129
Concept ID:
C0009080
Finding
Terminal broadening of the fingers (distal phalanges of the fingers).
Secretory diarrhea
MedGen UID:
75635
Concept ID:
C0267557
Disease or Syndrome
Watery voluminous diarrhea resulting from an imbalance between ion and water secretion and absorption.
Periosteal thickening of long tubular bones
MedGen UID:
322394
Concept ID:
C1834345
Finding
Thickening of the periosteum of long bone.
Seborrheic dermatitis
MedGen UID:
19912
Concept ID:
C0036508
Disease or Syndrome
Seborrheic dermatitis is a form of eczema which is closely related to dandruff. It causes dry or greasy peeling of the scalp, eyebrows, and face, and sometimes trunk.
Acne
MedGen UID:
152379
Concept ID:
C0702166
Disease or Syndrome
A skin condition in which there is an increase in sebum secretion by the pilosebaceous apparatus associated with open comedones (blackheads), closed comedones (whiteheads), and pustular nodules (papules, pustules, and cysts).
Hyperhidrosis
MedGen UID:
5690
Concept ID:
C0020458
Finding
Abnormal excessive perspiration (sweating) despite the lack of appropriate stimuli like hot and humid weather.
Thickened skin
MedGen UID:
66024
Concept ID:
C0241165
Finding
Laminar thickening of skin.
Cutis gyrata of scalp
MedGen UID:
78095
Concept ID:
C0263417
Disease or Syndrome
The presence of convoluted folds and furrows formed from thickened skin of the scalp, resembling cerebriform pattern. The scalp has convoluted and elevated folds, 1 to 2 cm in thickness. The convolutions generally cannot be flattened by traction.
Ptosis
MedGen UID:
2287
Concept ID:
C0005745
Disease or Syndrome
The upper eyelid margin is positioned 3 mm or more lower than usual and covers the superior portion of the iris (objective); or, the upper lid margin obscures at least part of the pupil (subjective).

Professional guidelines

PubMed

Lu Q, Xu Y, Zhang Z, Li S, Zhang Z
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Recent clinical studies

Etiology

Pang Q, Xu Y, Liao R, Li Y, Zhang L, Chi Y, Qi X, Li M, Jiang Y, Wang O, Xing X, Qin L, Xia W
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Ma GM, Chow JS, Taylor GA
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Munichandrappa P, Singh N, Thappa DM
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Ali N
JAAPA 2015 Jun;28(6):65-6. doi: 10.1097/01.JAA.0000462058.86000.b6. PMID: 25989437
Zhang Z, He JW, Fu WZ, Zhang CQ, Zhang ZL
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Diagnosis

Ikeda K, Miyamori D, Hirabayashi R, Ito M
QJM 2022 Sep 22;115(9):611-612. doi: 10.1093/qjmed/hcac147. PMID: 35731213
Martínez-Lavín M
Best Pract Res Clin Rheumatol 2020 Jun;34(3):101507. Epub 2020 Apr 11 doi: 10.1016/j.berh.2020.101507. PMID: 32291203
Saigal R, Chaudhary A, Pathak P, Singh A, Gupta D, Tank ML
J Assoc Physicians India 2016 Mar;64(3):88-89. PMID: 27731569
Callemeyn J, Van Haecke P, Peetermans WE, Blockmans D
Acta Clin Belg 2016 Jun;71(3):123-30. Epub 2016 Apr 22 doi: 10.1080/17843286.2016.1152672. PMID: 27104368
Gibb C, Smith PJ, Miller R
Br J Hosp Med (Lond) 2013 Nov;74(11):C170-2. doi: 10.12968/hmed.2013.74.sup11.c170. PMID: 24350360

Therapy

Biswas S, Narang H, Rajput MS, Makharia G
BMJ Case Rep 2022 May 17;15(5) doi: 10.1136/bcr-2021-247193. PMID: 35580956Free PMC Article
Zhang Z, Zhang C, Zhang Z
Front Med 2013 Mar;7(1):60-4. Epub 2013 Jan 23 doi: 10.1007/s11684-013-0246-6. PMID: 23345113
Gupta M, Lehl SS, Singh R, Sachdev A
BMJ Case Rep 2011 Sep 28;2011 doi: 10.1136/bcr.08.2011.4605. PMID: 22679327Free PMC Article
Dosik JS
Dermatol Online J 2001 Feb;7(1):11. PMID: 11328632
Naschitz JE, Rosner I, Rozenbaum M, Zuckerman E, Yeshurun D
Semin Arthritis Rheum 1999 Aug;29(1):43-55. doi: 10.1016/s0049-0172(99)80037-7. PMID: 10468414

Prognosis

Yap FY, Skalski MR, Patel DB, Schein AJ, White EA, Tomasian A, Masih S, Matcuk GR Jr
Radiographics 2017 Jan-Feb;37(1):157-195. Epub 2016 Dec 9 doi: 10.1148/rg.2017160052. PMID: 27935768
Callemeyn J, Van Haecke P, Peetermans WE, Blockmans D
Acta Clin Belg 2016 Jun;71(3):123-30. Epub 2016 Apr 22 doi: 10.1080/17843286.2016.1152672. PMID: 27104368
Munichandrappa P, Singh N, Thappa DM
Indian J Dermatol Venereol Leprol 2016 Jan-Feb;82(1):57-8. doi: 10.4103/0378-6323.172901. PMID: 26728812
Martinez-Lavin M
Best Pract Res Clin Rheumatol 2011 Oct;25(5):727-34. doi: 10.1016/j.berh.2011.10.019. PMID: 22142750
Vongpatanasin W, Brickner ME, Hillis LD, Lange RA
Ann Intern Med 1998 May 1;128(9):745-55. doi: 10.7326/0003-4819-128-9-199805010-00008. PMID: 9556469

Clinical prediction guides

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Seta V, Capri Y, Battistella M, Bagot M, Bourrat E
Ann Dermatol Venereol 2017 Dec;144(12):799-803. Epub 2017 Sep 12 doi: 10.1016/j.annder.2017.03.027. PMID: 28916395
Tanese K, Niizeki H, Seki A, Otsuka A, Kabashima K, Kosaki K, Kuwahara M, Miyakawa S, Miyasaka M, Matsuoka K, Okuyama T, Shiohama A, Sasaki T, Kudoh J, Amagai M, Ishiko A
J Dermatol 2015 Jul;42(7):710-4. Epub 2015 May 11 doi: 10.1111/1346-8138.12869. PMID: 25964088Free PMC Article
Stone OJ
Dermatol Clin 1985 Jul;3(3):485-90. PMID: 3830509

Recent systematic reviews

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