To the Editor:
—I am addressing this letter with regard to a paper published in the Archives of Surgery, to wit: "Clinical and Pathological Observations in Three Cases of Ainhum," by L. H. Riley Jr., and J. R. Cantrell (A.M.A. Arch. Surg. 79:1013-1017 [Dec.] 1959).I have noted that the authors refer to 71 patients reported in the United States, plus a possible 9 additional cases. I believe this figure to be somewhat on the low side. I would like to refer to a previous report—"Ainhum (Dactylosis Spontanea)" by M. L. Norton, A. M. Sala, and M. E. Silverstein (A.M.A. Arch Surg. 75:473-478 [Sept.] 1957)—where 102 cases were reported and reviewed, to which an additional case was added. Particular effort to assure that the review involved as few duplications as possible, was made, as indicated by the extensive bibliography.In addition, the article refers to pain being the primary symptom.