At first, the groove begins on the lower and internal side of the base of the fifth toe of both feet (in about 75 percent cases), becomes gradually deeper and more circular, progressing with slight pain, and the whole process could take a few months to a few years until the last stage of autoamputation occurs. And all the cases of Ainhum disease have been reported to begin in the fifth toe of the foot.
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X-RAY views of Ainhum Affected Feet |
In the maximum cases, Ainhum or Dactylolysis Spontanea has been confused with near similar constrictions caused by other diseases such as leprosy, diabeticgangrene, scleroderma or Vohwinkel syndrome, syringomyelia. In this case, it is called Pseudo-Ainhum which is treatable with minor surgery or the treatments as with Ainhum. Pseudo-Ainhum has even been seen in psoriasis or it is acquired by the wrapping toes, penis or nipple with hairs, threads or fibers. [source]