Dermatology: Practical and Conceptual


Image Letter  |  Dermatol Pract Concept 2020;10(4):2020092 1

Dermatology Practical & Conceptual

Case Presentation 

An otherwise healthy 9-year-old boy presented with itching 

and painful lesions on both thumbs of 5 months’ evolution. 

He had received treatment with high-potency topical corti-

costeroids with partial improvement. Physical examination 

showed erythema, lichenification and fissures on the tips of 

both thumbs (Figure 1). Patch testing was performed, with 

negative results. After exhaustive questioning, the parents 

stated that the child usually spent several hours per day play-

ing video games. The boy also admitted to being “addicted to 

PlayStation games.” A diagnosis of frictional dermatitis was 

made. The lesions completely resolved following 2 weeks of 

forced abstinence from video gaming. 

Teaching Point

Among the cutaneous manifestations of excessive video 

gaming, video gamer thumb or “playstation thumb” refers 

to the presence of hyperkeratosis, blisters, and petechiae on 

the tips of the thumbs [1]. Multiple cutaneous disorders can 

arise from excessive use of electronic devices [2], and a high 

index of suspicion is necessary to allow an early diagnosis. 

References

1. Wolf R, Wolf D. Playstation thumb. Int J Dermatol. 

2014;53(5):617-618. DOI: 10.1111/ijd.12368. PMID: 24602007.

2. Jalink MB, Heineman E, Pierie JP, ten Cate Hoedemaker HO. 

Nintendo related injuries and other problems: review. BMJ. 2014 

16;349:g7267. DOI: 10.1136/bmj.g7267. PMID: 25515525.

Playstation Thumb: Frictional Dermatitis Caused  
by Excessive Video Game Playing

Jaime Piquero-Casals1, Daniel Morgado-Carrasco2, Juan Francisco Mir-Bonafé3,  
Eduardo Rozas-Muñoz4

1 Department of Dermatology, Dermik, Clínica Dermatológica Multidisciplinar, Barcelona, Spain

2 Department of Dermatology, Hospital Clínic de Barcelona, Universitat de Barcelona, Spain

3 Department of Dermatology, Hospital Son Llàtzer, Palma de Mallorca, Spain

4 Department of Dermatology, Hospital de San Pablo, Coquimbo, Chile

Key words: playstation thumb, texting thumb, video game; nintendinitis, frictional dermatitis, tech thumb

Citation: Piquero-Casals J, Morgado-Carrasco D, Mir.Bonafé JF, Rozas-Muñoz E. Playstation thumb: frictional dermatitis caused by 
excessive video game playing. Dermatol Pract Concept. 2020;10(4):e2020092. DOI: https://doi.org/10.5826/dpc.1004a92

Accepted: June 1, 2020; Published: October 26, 2020

Copyright: ©2020 Piquero-Casals et al. This is an open-access article distributed under the terms of the Creative Commons Attribution 
License BY-NC-4.0, which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original 
author and source are credited.

Funding: None.

Competing interests: The authors have no conflicts of interest to disclose.

Authorship: All authors have contributed significantly to this publication.

Corresponding author:Jaime Piquero-Casals, MD, PhD, Dermik, Clínica Dermatológica Multidisciplinar, Carrer de les Escoles Pies, 7, 
08017, Barcelona, Spain. Email: j.piquero@dermik.es



2 Image Letter  |  Dermatol Pract Concept 2020;10(4):2020092

Figure 1. Erythema, lichenification and fissures on the tips of both 

thumbs.