Thinker's Sign

Thinker's sign, also called the Dahl sign, is a dermatologic sign of chronic obstructive pulmonary disease (COPD), characterized by hyperpigmented, bilateral, callused patches triggered by continuous tripod posture. It also can be associated with bilateral hyperkeratosis and hyperpigmentation o...

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Bibliographic Details
Main Authors: Eduardo Smelin Perdomo Domínguez, Héctor M. Ramos-Zaldívar
Format: Article
Language:English
Published: American College of Physicians 2024-03-01
Series:Annals of Internal Medicine: Clinical Cases
Online Access:https://www.acpjournals.org/doi/10.7326/aimcc.2023.1326
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Summary:Thinker's sign, also called the Dahl sign, is a dermatologic sign of chronic obstructive pulmonary disease (COPD), characterized by hyperpigmented, bilateral, callused patches triggered by continuous tripod posture. It also can be associated with bilateral hyperkeratosis and hyperpigmentation of the forearms and elbows. Although the incidence of thinker's sign in severe COPD has not been well established, its potential diagnostic value is worth noting, as it can unmask the magnitude of the underlying disease. We report the case of a Honduran Garifuna woman with thinker's sign on both thighs and elbows, associated with clinical features of COPD.
ISSN:2767-7664