Actas dermo-sifiliográficas
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Actas Dermosifiliogr · May 2005
Case Reports[Mechanic's hands: a characteristic cutaneous sign of antisynthetase syndrome].
"Mechanic's hands" are a characteristic cutaneous sign of idiopathic inflammatory myositis. We describe the case of a 61-year-old male patient who was diagnosed with idiopathic polymyositis and non-specific interstitial lung disease in 1999, and three years later developed scaly, fissured hyperkeratotic lesions on the lateral and palmar surfaces of the first three fingers of both hands, with little pruritus. The presence of the anti-Jo-1 antisynthetase antibody in the patient's serum, the finding of skin lesions characteristic of "mechanic's hands" and the patient's other systemic clinical manifestations made it possible to establish the diagnosis of "antisynthetase syndrome."
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Pain is difficult to measure, as it has a significant subjective component. This symptom, and in particular its psycho-emotional component (fear prior to the operation and a feeling of release afterwards), has not been studied extensively. We decided to quantitatively evaluate its perception in local surgery, in relation to different moments during the operation and using the application of a topical anesthetic cream as an external variable. ⋯ Patients think that the surgery will hurt more than it really does, and they also immediately erase the memory of the recent pain. The use of EMLA does not modify the patient's idea of how much the operation will hurt, but the patient does perceive less pain than those who do not use it. It is important to reassure patients about their operations so that they do not become overly anxious about the procedures, thus minimizing their perception of pain. The use of a topical local anesthetic in the area of the surgery could help decrease the sensation of pain.