INITIAL ACROOSTEOLYSIS ULCERO-MUTILANS IN 2 BROTHERS WITH HEREDITARY TYPE-I MOTOR SENSORY NEUROPATHY

Two brothers aged 43 and 39, presented with indolent ulcerations with hyperkeratotic margins at the lateral sole of the feet. Both patients complained of pes cavus-like deformation. There was no history of diab etes mellitus or alcohol abuse. Neurologic examinations revealed glove -stocking impairment of all sensory modalities, paresis and atrophy of the intrinsic musculature of the feet and lower legs. Motor nerve con duction velocity measurements were markedly slowed. Roentgenologic fin dings consisted of osteolysis in the bones of the feet in regions of i ncreased pressure. Clinical findings, history and neurological examina tions confirmed the diagnosis of familial acro-osteolysis ulcero-mutil ans (Thevenard syndrome) based on an hereditary type I motor sensory n europathy.