Abnormal Hair Growth in the Hand over the First Dorsal Interosseus Muscle as a Part of Reflex Sympathetic Dystrophy: A Clinical Image
Reflex sympathetic dystrophy (RSD), also known as complex regional pain syndrome (CRPS) is a complex syndrome of pain and stiffness with vasomotor instability that can affect any part of the body but, more common in the hand and the leg . It is a well-known complication to hand surgeons. The clinical features of this syndrome were described in a paper by Bruscas et al in 2010 where they prospectively followed up 171 patients diagnosed with RSD. They noted that trauma was the commonest trigger in most cases . In a paper prospectively analyzing 101 carpal tunnel decompressions (CTD) de Costa, de Oliveira et al noted an incidence of 2.1% following CTD. Both our patients were following volar locking plating of distal radial fractures.
These photographs illustrate a rare association of RSD/CRPS where it is accompanied with abnormal growth of hair confined to the distribution of a nerve and in these two cases it was thesensory distribution of the radial nerve. Clear photographs of this phenomenon are not encountered in the literature. Using the key word combinations of reflex sympathetic dystrophy causing abnormal hair growth in the hand; RSD, abnormal growth of hair in hand; we were not able to find articles in the literature in a PubMed search.
We are unaware as to whether this association would have any impact on the eventual prognosis of our patients. We are following them up and at the moment. The patients are in their third month of follow up. The stiffness and pain of the hands caused by reflex sympathetic dystrophy have settled well.
1. de Costa W, de Oliveira SB, Fernandes Mdo C, Saraiva Ra. Incidence of regional pain syndrome after carpal tunnel release. Is there a correlation with the anaesthetic technique? Rev Bras Anestesiol. 2011; 61: 425-433.