eMedicine Specialties > Dermatology > Diseases of the Dermis

Ainhum: Treatment & Medication

Author: Samuel Selden, MD, Assistant Professor, Department of Dermatology, Eastern Virginia Medical School
Contributor Information and Disclosures

Updated: Mar 13, 2009

Treatment

Medical Care

No current treatment appears to halt the progression of ainhum.

  • In the early stages of ainhum, treatment with salicylic acid ointment applications and intralesional steroid injections (20-40 mg/mL triamcinolone acetonide suspension) have been reported to reduce pain.11
  • Pseudoainhum may respond to treatment with etretinate.

Surgical Care

  • If discovered late, the definitive treatment for ainhum may be surgical amputation (if not autoamputation). The best treatment may be Z-plasty, which involves releasing the constricting base through a Z-shaped repair after surgical amputation.12
  • In the early stages of ainhum, division of the fibrous band has been reported to reduce pain.
  • In pseudoainhum, congenital bands rarely need treatment other than surgery.

More on Ainhum

Overview: Ainhum
Differential Diagnoses & Workup: Ainhum
Treatment & Medication: Ainhum
Follow-up: Ainhum
Multimedia: Ainhum
References
[ CLOSE WINDOW ]

References

  1. Greene JT, Fincher RM. Case report: ainhum (spontaneous dactylolysis) in a 65-year-old American black man. Am J Med Sci. Feb 1992;303(2):118-20. [Medline].

  2. Mendelson DS, Chan KF, Song IS. Spontaneous dactylolysis with pain in a 58-year-old American Black man. JAMA. Oct 2 1981;246(14):1591-2. [Medline].

  3. da Silva Lima JF. On ainhum. Arch Dermatol. 1880;6:367.

  4. Olivieri I, Piccirillo A, Scarano E, Ricciuti F, Padula A, Molfese V. Dactylolysis spontanea or ainhum involving the big toe. J Rheumatol. Dec 2005;32(12):2437-9. [Medline].

  5. Cole GJ. Ainhum: An account of fifty-four patients with special reference to etiology and treatment. J Bone Joint Surg Br. Feb 1965;47:43-51. [Medline].

  6. Wells TL, Robinson RC. Annular constrictions of the digits. AMA Arch Derm Syphilol. Nov 1952;66(5):569-72. [Medline].

  7. Cunliffe WJ. Ainhum and pseudo-ainhum. In: Rook A, Wilkinson DS, Ebling FJ. Textbook of Dermatology. Vol 2. Oxford: Blackwell Scientific; 1979:1638.

  8. Demis DJ. Ainhum, pseudoainhum, and tourniquet syndrome. In: Demis DJ, Dobson RL, McGuire J. Clinical Dermatology. 7th ed. Hagerstown, Md: Harper & Row; 1979:4-47.

  9. Fetterman LE, Hardy R, Lehrer H. The clinico-roentgenologic features of ainhum. Am J Roentgenol Radium Ther Nucl Med. Jul 1967;100(3):512-22. [Medline].

  10. Jemmott T, Foster AV, Edmonds ME. An unusual cause of ulceration: ainhum (dactylolysis spontanea). Int Wound J. Sep 2007;4(3):251-4. [Medline].

  11. Rossiter JW, Anderson PC. Ainhum: treatment with intralesional steroids. Int J Dermatol. Jun 1976;15(5):379-82. [Medline].

  12. Allyn B, Leider M. Dactylolysis spontanea (ainhum). Report of a case treated by the surgical procedure known as Z-plasty. JAMA. May 25 1963;184:655-7. [Medline].

  13. Browne SG. Ainhum. Int J Dermatol. Jun 1976;15(5):348-50. [Medline].

  14. Dent DM, Fataar S, Rose AG. Ainhum and angiodysplasia. Lancet. Aug 22 1981;2(8243):396-7. [Medline].

  15. Hunt M, Glucksman EE. Ainhum presenting to the accident and emergency department. Arch Emerg Med. Dec 1993;10(4):324-7. [Medline].

  16. Kean BH, Tucker HA, Miller WC. Ainhum: a clinical summary of forty-five cases on the Isthmus of Panama. Trans R Soc Trop Med Hyg. 1946;39:331-4.

  17. Ramesh V, Misra RS, Mahaur BS. Pseudoainhum in porokeratosis of Mibelli. Cutis. Feb 1992;49(2):129-30. [Medline].

  18. Schulz EJ. Genodermatoses. Dermatol Clin. Oct 1994;12(4):787-96. [Medline].

  19. Sharma RC, Sharma AK, Sharma NL. Pseudo-ainhum in discoid lupus erythematosus. J Dermatol. Apr 1998;25(4):275-6. [Medline].

[ CLOSE WINDOW ]

Further Reading

[ CLOSE WINDOW ]

Keywords

ainhum, dactylolysis spontanea, bankokerend, sukhapakla, autoamputation of a digit, pseudoainhum, pseudo-ainhum, annular constriction of a digit

[ CLOSE WINDOW ]

Contributor Information and Disclosures

Author

Samuel Selden, MD, Assistant Professor, Department of Dermatology, Eastern Virginia Medical School
Samuel Selden, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Astellas Pharma US, Inc. Honoraria Consulting; Galderma Laboratories, L.P. Honoraria Review panel membership

Medical Editor

Smeena Khan, MD, Private Practice, Adult and Pediatric Dermatology Associates
Smeena Khan, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology
Disclosure: Nothing to disclose.

Pharmacy Editor

Richard P Vinson, MD, Assistant Clinical Professor, Department of Dermatology, Texas Tech University School of Medicine; Consulting Staff, Mountain View Dermatology, PA
Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Association of Military Dermatologists, Texas Dermatological Society, and Texas Medical Association
Disclosure: Nothing to disclose.

Managing Editor

Jeffrey J Miller, MD, Associate Professor of Dermatology, Penn State University College of Medicine; Staff Dermatologist, Penn State Milton S Hershey Medical Center
Jeffrey J Miller, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, Association of Professors of Dermatology, North American Hair Research Society, and Society for Investigative Dermatology
Disclosure: Nothing to disclose.

CME Editor

Joel M Gelfand, MD, MSCE, Medical Director, Clinical Studies Unit, Assistant Professor, Department of Dermatology, Associate Scholar, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania
Joel M Gelfand, MD, MSCE is a member of the following medical societies: Society for Investigative Dermatology
Disclosure: AMGEN Consulting fee Consulting; AMGEN Grant/research funds None; Genentech Consulting fee Consulting; Centocor Consulting fee Consulting; Centocor Grant/research funds None; Covance Consulting fee Consulting; Shire  Consulting

Chief Editor

William D James, MD, Paul R Gross Professor of Dermatology, University of Pennsylvania School of Medicine; Vice-Chair, Program Director, Department of Dermatology, University of Pennsylvania Health System
William D James, MD is a member of the following medical societies: American Academy of Dermatology and Society for Investigative Dermatology
Disclosure: elsevier Royalty Other; american college of physicians Honoraria Other

 
 
HONcode

We subscribe to the
HONcode principles of the
Health On the Net Foundation

All material on this website is protected by copyright, Copyright© 1994- by Medscape.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.