Palmar Digital Vein Thrombosis: A Case Report and Review of 36 Cases.

Thrombosis of the palmar digital veins is relatively rare, typically reported in women aged 35-65 years and most commonly occurring on the fourth digit. Clinical presentation varies and the lesion can present on the fingers or the palms of the hands. Diagnosis may be suspected clinically and confirmed on histology and radiologically. The condition can be managed conservatively or surgically. A 58-year-old woman presented with a 3-month history of a tender, skin-coloured nodule on her right palm. This was surgically excised, and the histopathological diagnosis was a thrombosed varix. As no underlying medical issues were raised on further testing, it was thought that her thrombosed varix was likely secondary to repeated trivial mechanical trauma, given that she was a housewife. A literature review yielded 36 cases of thrombosed varix, including our case. Most cases (85.3%) occurred in females, and the mean age of patients was 51.67 years, with two-thirds of patients between 35 and 65 years of age. The fourth digit and the proximal interphalangeal joint were the most commonly affected sites, respectively. Although rare, doctors should consider the possibility of a thrombosed varix when presented with tender and raised nodules on the palms or fingers. LEARNING POINTS: Thrombosis of the palmar digital veins is rare but can occur secondary to mechanical trauma and hypercoagulable states.Physicians should consider the possibility of a thrombosed varix when presented with a tender, raised and firm nodule on the hand or fingers, especially since some cases may be associated with hypercoagulable states which can have more serious sequelae.

Endothelium-dependent relaxation mechanisms involve nitric oxide and prostanoids in the isolated bovine digital vein.

Endothelial dysfunction contributes to the development of ungulate's laminitis. Although extensively studied in equines, the endothelial function is not fully examined in bovine digital veins (BDVs). BDVs were studied under isometric conditions to describe the acetylcholine (ACh) endothelium-dependent relaxation. Concentration-response curves were constructed to phenylephrine, ACh, and sodium nitroprusside (SNP). Relaxation responses were evaluated using either phenylephrine or depolarizing high-potassium Krebs solution (DKS) as precontraction agents. Endothelium denudation and incubation with L-NAME (300 µM), indomethacin (10 µM) or both were used to explore endothelial-mediated mechanisms. Endothelium denudation did not modify phenylephrine and SNP responses, however, significantly (p < 0.05) converted a relaxation (63.2 ± 5%) response to ACh into a contraction (30.3±9%). The ACh-evoked relaxation was significantly (p < 0.05) reduced in the presence of indomethacin (37.5 ± 6%) and L-NAME (6.40 ± 2%). The presence of both inhibitors abolished the ACh-evoked relaxation. Although DKS caused a higher precontraction than phenylephrine, ACh-evoked relaxation (22.4 ± 3.4%) was still observed and was reduced by the combination of inhibitors (7.0 ± 1.0%). The ACh endothelium-dependent relaxation in BDVs is essentially mediated by nitric oxide and endothelium-derived prostanoids. The BDV endothelium function is a dynamic component in the control of the bovine digital blood flow, particularly under endothelial dysfunction conditions when venoconstriction might lead to postcapillary resistance increase.

Valor de la vena digital para el diagnóstico tradicional y pronóstico de las diarreas en una lactante / Value of the digital vein for the traditional diagnosis and prognosis of diarrheas in an infant

Se presenta el caso clínico de una lactante de 8 meses de edad, de procedencia rural, quien ingresa en el Hospital Docente Infantil Norte de Santiago de Cuba por presentar fiebre, vómitos y diarreas. Se le realizó examen físico y observación de la vena digital, cuyo resultado desde el punto de vista de la medicina tradicional fue diarrea por frío-humedad, para lo cual se orientó una estrategia terapéutica que favoreció la mejoría del cuadro diarreico y emético, sin el empleo de medicamentos

The case report of an 8 months infant is presented. She had rural origin and is admitted to the Northern Teaching Children Hospital in Santiago de Cuba due to fever, vomits and diarrheas. Physical examination and observation of the digital vein was carried out whose result from the traditional medicine point of view was diarrhea due to cold-humidity, for which a therapeutic strategy was guided that favored the improvement of the diarrheal and emetic pattern, without using medication

Change in vascular smooth muscle response to 5-HT due to short- or long-term endothelial denudation of the bovine digital vein.

Several chronic progressive vascular diseases, such as laminitis, show vasocontractile dysfunction that might evolve into reperfusion injury and/or vessel structural remodelling, which may be traced back to aberrant endothelial function. In the present study, the vasomotor responses of bovine digital veins (BDVs) to 5-hydroxytryptamine (5-HT) were investigated in blood vessels, with and without endothelium present, and in samples deprived of endothelium before or after overnight incubation in tissue culture medium, to evaluate the effects of short- and long-term endothelial damage on vascular smooth muscle (VSM) reactivity. No significant effects were observed in the blood vessels tested immediately after the removal of endothelium. In contrast, a significant increase in VSM reactivity to 5-HT was seen in vessels incubated without endothelium. This long-term change in smooth muscle reactivity was prevented by exposure to the nitric oxide (NO) donor nitroprusside (P < 0.01), suggesting that the long-term lack of inhibitory control exerted by endothelium-derived NO is involved in increased VSM reactivity. The RhoA/ROCK pathway inhibitor fasudil reduced VSM hyper-contractility to ~65% (P < 0.001), the superoxide dismutase-mimetic tempol normalised the vascular response and the non-selective COX-inhibitor indomethacin exerted a moderate inhibitory effect (P < 0.05). Thus, over-activation of the RhoA/ROCK pathway and production of reactive oxygen species could account for VSM hyper-reactivity, triggered by long-term endothelium-deprivation in BDVs, suggesting that these biochemical mechanisms are potential targets for controlling the progressive vasocontractile dysfunction of digital veins in animals affected with laminitis.

A Case of Palmar Digital Vein Thrombosis / 대한피부과학회지

No abstract available.

A Case of Isolated Plantar Digital Vein Thrombosis / 대한피부과학회지

Plantar vein thrombosis is a rare condition, which can cause foot pain when walking. The cause of thrombosis is not clear. We experienced a case of plantar digital vein thrombosis which occurred in the left big toe. The patient was a 35-year-old man who presented with foot pain when during walking since one month ago. There was a solitary skin colored nodule on the left big toe. Skin punch biopsy was performed, and the diagnosis of plantar digital vein thrombosis was made. Plantar digital vein thrombosis is a very rare cause of toe pain. We herein report this interesting case.

Palmar Digital Vein Thrombosis / 대한피부과학회지

Palmar digital vein thrombosis causing one or more nodules seems to be a relatively rare condition. Only 20 cases of palmar digital vein thrombosis have been reported worldwide in the English language literature. It presents with a painful, firm and blue nodule located at or in close proximity to one of the flexion creases. The etiology remains unknown, but changes in the vessel wall related to the anatomic characteristics of the palmar digital veins may play a role, along with intraluminal stasis. Two patients with blue nodule located in close proximity to flexion creases on the volar side of the finger presented to our hospital. Histological examination showed organizing thrombus within the dilated vessel. We report here on these two cases of palmar digital vein thrombosis.