Pseudo-Ainhum of the Left Hallux Complicated by Osteitis: A Rare Clinical Presentation

Introduction: Pseudo-ainhum is a disorder of unknown etiology, generally congenital and non-progressive. According to one theory, it is caused by in utero constriction of amniotic bands. These constriction bands result in a less aesthetically pleasing foot and lead to long-term neurovascular compromise, potentially resulting in finger amputation. It can occur at any age, regardless of race, and is associated with conditions involving advanced peripheral neuropathy and/or vascular disorders affecting the extremities. Pseudo-ainhum (PA) is characterized by circumferential ulceration of one or more toes and/or fingers, often painless, which can ultimately lead to amputation.

Observation: A 60-year-old Beninese housewife, with no notable medical history, consulted the Dermatology-Venereology department of the Buruli Ulcer Screening and Treatment Center (CDTUB) in Allada for a loss of tissue at the base of the left hallux, which had been progressing continuously for one year with periods of remission. The condition reportedly began over five years ago with a spontaneous deformation of the hallux, initially painless. The patient had consulted a traditional healer, who treated her with topical herbal medicine under occlusion. one or more toes and/or fingers, often painless, which can ultimately lead to amputation. On physical examination, a circular constriction was observed at the proximal third of the left hallux, with an overlying oval-shaped ulceration measuring approximately 1 x 0.5 mm in diameter. The ulcer surface revealed a small opening through which foul-smelling purulent fluid was draining. The diagnosis of pseudo-ainhum of the left hallux complicated by osteitis was confirmed, and a disarticulation was performed (. There was a favorable postoperative outcome after 17 days.

Conclusion: Pseudo-ainhum is a benign condition; it is often considered a clinical sign when it occurs in a syndromic context, particularly in the pediatric population. Awareness of this condition is essential, especially in recognizing its benign nature.

Keywords: Pseudo-Ainhum, Hallux, Left, Osteitis.