Ainhum Differential Diagnoses

Updated: May 02, 2017
  • Author: Jeannette Rachel Jakus, MD, MBA; Chief Editor: Dirk M Elston, MD  more...
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Diagnostic Considerations

Also consider the following:


Initial fissuring beneath toes may be mistaken for trauma or infection. Dermatophytosis complex may be a complication. In the tropics, where most true ainhum occurs, Hansen disease, syphilis, yaws, and tuberculosis must be excluded. Radiographically, osteolytic lesions may be observed both after trauma and in ainhum.

Following dactylolysis, ainhum may be confused with traumatic amputations, limb aplasia or hyperplasia, diabetic or vascular gangrene, or tourniquet syndrome (from human hair).


Pseudoainhum [11, 12] most commonly is associated with scleroderma, Hansen disease, syringomyelia, and atypical keratoderma. Pseudoainhum refers to congenital annular bands or constrictions resulting from trauma or linked to other diseases. [13]

Congenital bands usually constrict an extremity, but may encircle any portion of the body, and result from congenital collagen dysplasia and not from scarring. The bands frequently are associated with other congenital or developmental anomalies.

Dermatologic syndromes associated with constrictive bands include amniotic band syndrome, multiple pterygium syndrome, Olmsted syndrome, popliteal pterygium syndrome, tourniquet syndrome, psoriasis, [14] discoid lupus erythematosus, [9] and Vohwinkel syndrome. [15, 16, 17]

Differential Diagnoses