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The clinical findings of bulbous distal digits plus more than 180º in Lovibond’s angle (the junction between the posterior nail fold and the nail plate) characterize digital clubbing, also known as Hippocratic fingers (after Hippocrates, who allegedly first described the condition). Clubbing may be a sign of serious systemic disease, including pulmonary disorders; it is also the primary sign of hypertrophic osteoarthropathy, an idiopathic form of this condition. Distal acroosteolysis, distal skin thickening, excessive sweating, and patent ductus arteriosus are common in the hereditary forms of clubbing.
Uppal and colleagues examined affected members of families with idiopathic hypertrophic osteoarthropathy and identified mutations in HPGD, t…