Extension-elicited blanching of the dorsal phalanges in systemic sclerosis - Video Data

Systemic sclerosis (SSc) is a multisystem disease that normally first manifests in the skin. To help differentiate early pathogenic phalangeal edema that often precedes finger skin thickening from normal variants, we report the clinical sign of extension-elicited blanching of the dorsal phalanges associated with SSc. We often observe this blanching phenomenon of the dorsal phalanges in our patients with early-stage disease (Video 1). However, attention to this clinical sign has been underreported and provides an additional clue toward diagnosing SSc. To appreciate pathogenic phalangeal blanching associated with SSc, patients make a fist with their hands and hold it. Upon releasing the fist and fully extending the phalanges, blanching of the dorsal aspects of their fingers can be elicited. The blanching ranges from the metacarpophalangeal joints over the proximal phalanges and proximal interphalangeal joints to the middle phalanges. It can be present symmetrically in all five fingers but is often less prominent on the thumbs.

系统性硬化症（Systemic sclerosis, SSc）是一种多系统疾病，通常首发于皮肤。为协助鉴别常先于手指皮肤增厚出现的病理性指骨水肿与正常生理变异，本文报道一种与SSc相关的、伸指诱发的指背苍白临床体征。我们在早期SSc患者中常可观察到此指背苍白现象（视频1）。但目前该临床体征的临床关注度较低，其可为SSc的诊断提供额外辅助线索。若要观察与SSc相关的病理性指骨苍白体征，患者需双手握拳并保持该姿势。松开拳头并完全伸展指骨后，即可诱发手指背侧出现苍白。该苍白区域可累及掌指关节、近节指骨、近端指间关节至中节指骨。该体征可对称累及全部五指，但拇指的苍白表现通常较轻。