Carpaletunnelsyndroom: een atypische presentatie

Carpal tunnel syndrome: an atypical presentation In this report, we present a case of distinct dermatological lesions in a patient with a new diagnosis of polymyalgia rheumatica (PMR) who developed a bilateral carpal tunnel syndrome (CTS). There are rare reports of dermatological signs of CTS in literature with inconclusive pathogenic theories. The unique aspect of this patient is hyperhidrosis and vasomotor reactions of the skin localized to one particular area: the innervation area of the palmar cutaneous branch of the median nerve (PCBm). The PCBm travels partially through the carpal tunnel, and then crosses the retinaculum to the surface. Additionally, up to 56% of patients with CTS have abnormal sensory conduction of the PCBm. Electromyography was performed, showing a bilateral CTS, and also a significant delay in the sensory nerve conduction of the PCBm. To our knowledge, this is the first report of involvement of the PCBm causing dermatological signs associated with CTS.