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Apr 2012

Recurrent Blistering of the Fingertips as a Sign of Carpal Tunnel Syndrome: An Effect of Nerve Compression

Author Affiliations

Author Affiliations: Department of Dermatology and Venereology, Second University of Naples, Naples, Italy.

Arch Dermatol. 2012;148(4):545-546. doi:10.1001/archdermatol.2011.3199

Carpal tunnel syndrome (CTS) rarely presents with dermatologic signs such as blistering, ulceration, hypohidrosis, contact dermatitis, and Raynaud phenomenon.1-3

A 66-year-old woman with diabetes presented with a history of relapsing blisters of the first 3 fingertips of the left hand associated with weakness and sensory loss. The blisters first occurred 6 months prior to presentation, became hemorrhagic in 4 or 5 days, and healed within 3 weeks without leaving scars. Dermatologic examination revealed only 1 hemorrhagic blister and residual desquamation on the second and third left fingertips (Figure). Mucosae were not affected. Diagnoses of autoimmune bullous dermatosis and infection were excluded by negative antibody titers and microbiologic screenings. Bullous diabeticorum was suspected, but no explanation was found to justify blisters only in the area of sensory loss. Neurologic examination showed hyposthenia and hypoesthesia. Tinel test results were positive.

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