Ainhum (Dactylolysis Spontanea): A Rare Cause of Consult in Dermatology- A Case Report and Review of Literature

Case Report

Austin J Dermatolog. 2017; 4(1): 1068.

Ainhum (Dactylolysis Spontanea): A Rare Cause of Consult in Dermatology- A Case Report and Review of Literature

González LF¹*, González CA², Motta A1,3 and Rodríguez F4

¹Dermatology Program, El Bosque University, Colombia

²Dermatology Service, Kennedy Hospital, Colombia

³Dermatology Service, Simón Bolívar Hospital, Colombia

4Radiology Service, Colombia Clinic, Colombia

*Corresponding author: Luis Fernando González, Dermatology Program, El Bosque University, Av. Cra. 9 # 131A 02. Bogotá, Colombia

Received: December 19, 2016; Accepted: January 16, 2017; Published: January 19, 2017


Ainhum or Dactylolysis Spontanea is an idiopathic condition due to constriction rings or grooves on the digits that result in auto amputation. The ainhum commonly affects the fifth toe and usually the compromise is bilateral. This disease affects mainly African American adults between 20 to 50 years old from tropical and sub-tropical regions. We report a 75 years-old man with clinical and radiographic findings of unilateral ainhum of left fifth toe.

Keywords: Ainhum; Amputation; Dactylolysis spontanea


The term ainhum or Dactylolysis Spontanea was used for first time by da Silva Lima in 1867 [1,2]. It is believed that the word “ainhum” derives from the Brazilian word “Nago” meaning ‘fissure’ or the Nigerian word “Yoruba” meaning ‘to saw’ [1]. This condition is a rare cause of consult in dermatology due to the low prevalence; however, the ainhum represents a term of confusion with its counterpart pseudo-ainhum. Ainhum or Dactylolysis Spontanea is used for describe African or African descendent patients with a clinical history of a groove or fissure of constricting tissue around the proximal end of the digits that affects mainly the fifth toe [1]. Meanwhile, pseudoainhum is any case of auto-amputation independent of race that may classify in two spectra ‘primary pseudo-ainhum’ or ‘secondary pseudo-ainhum’ depending the age of presentation and the associated conditions [2]. We report an African American descendent adult with clinical history consisting with classic ainhum or Dactylolysis Spontanea.

Case Presentation

A 75 years old African descendent male from Tumaco, Colombia, is presented to our clinic with a history of 1 year of a groove on the left fifth toe associated to pain and disability. The patient has history of arterial hypertension controlled. On physical examination is observed a constrictive band on the distal phalange of left fifth toe (Figure 1). A skin biopsy was performed with evidence of dermis fibrosis without findings suggested active localized scleroderma. Autoimmune profile was unremarkable, VDRL titers were no reactive and Hansen’s disease was ruled out. Radiographs showed evidence of a constricting band in the middle of proximal phalanx of fifth left toe associated with thinning of bone consisting with ainhum grade III. Figure 2 a surgical management by orthopedic surgery was performed. The pain and discomfort was improved without any important disability posterior to the distal amputation of affected digit.