Abstract

A 22‐year‐old male presented with extensive skin folding on the forehead, severe acne and scaly skin eruption with seborrheic distribution. No family history of similar condition or consanguinity noted. Examination revealed cutis vertices gyrate over the forehead, seborrhoea, acne and seborrheic dermatitis. Moreover, clubbing of his fingers and toes was noted and he had swollen knee joints. Radiological evaluation revealed hypertrophic osteoarthropathy. Skin biopsy findings showed sebaceous hyperplasia with thickening of the dermis with mucin deposition compatible with pachydermoperiostosis. However no other associations were found after through biochemical, haematological and radiological work up. primary PDP was diagnosed based on the typical clinical and radiological findings. The patient was referred to plastic surgical clinic for further management of cutis vertices gyrata where it was arranged Botox injections without surgical correction-but later we discussed with them regarding the nature of the disease and offered surgical correction for the patient. It was arranged the surgical correction instead of Botox.