Diagnostician's Digit

Abstract

Percussion, described by Dr Leopold Auenbrugger in 1761, has long been a tool used by the physician as a technique in the art of physical diagnosis.1One method, bimanual indirect or mediate, is done by placing the left long finger on the body surface to be percussed to serve as a pleximeter. The area about the distal interphalangeal joint is struck a sharp blow with the tip of the flexed right long finger, the plexor.2 An octogenarian physician, a practicing internist, graduated from medical school in 1936 and has been using the art of digital percussion for more than 62 years, including his time as a medical student. The posttraumatic hyperpigmentation with central hypopigmentation and atrophic changes are a result of innumerable repetitions of the technique of bimanual indirect percussion. The physician first noticed the lesion more than 5 years ago. A similar lesion does not exist on