Ms. Simran Kaur was a 28-year-old woman living in Mohali, Punjab. She worked as an online customer support executive, a role that required regular computer use, typing, and communication throughout her working hours. She was unmarried and lived with her mother, Mrs. Harpreet Kaur, who served as her primary caregiver. Her sister, Ms. Navneet Kaur, provided additional support when needed.

Simran was born with EEC syndrome, a rare genetic condition that affected multiple systems in her body. The name EEC stands for Ectrodactyly-Ectodermal Dysplasia-Cleft syndrome. Each part of this name describes a different group of possible features. Ectrodactyly refers to differences in the fingers or toes. Ectodermal dysplasia involves structures derived from the ectoderm, which include the skin, hair, teeth, sweat glands, and eyes. The cleft component refers to possible cleft lip or cleft palate.

In Simran’s case, the condition primarily affected her hands, feet, skin, teeth, and eyes to varying degrees. She had undergone reconstructive procedures during both childhood and adulthood to improve the function of her hands and feet. These earlier surgeries helped her achieve a reasonable level of independence. She could manage most daily activities on her own, communicate effectively, use a computer with some adaptations, and walk without assistance.

However, over time, she noticed progressive difficulty with her left hand. The functional problems worsened gradually. Routine tasks that she had previously managed became harder. She experienced increased stiffness, reduced grip strength, and more difficulty with fine motor activities such as buttoning clothes, holding small objects, and writing for extended periods. After clinical evaluation, her surgical team recommended a planned reconstructive procedure on her left hand to address the progressive functional decline.

Her associated medical conditions included chronically dry and sensitive skin related to ectodermal dysplasia, dental abnormalities that required ongoing routine care, structural differences in her feet that caused mild discomfort after prolonged walking, and occasional dry-eye symptoms managed with ophthalmological follow-up as needed. These associated conditions were stable and did not require acute intervention at the time of her hand surgery.

The primary diagnosis was EEC syndrome (Ectrodactyly-Ectodermal Dysplasia-Cleft syndrome). This is a rare inherited condition with variable expression, meaning that different people with the same genetic diagnosis can have very different clinical features. The condition is typically caused by mutations in the TP63 gene and follows an autosomal dominant inheritance pattern, though not all cases have a clearly identified genetic cause.

Simran’s specific clinical features related to her EEC syndrome included abnormal finger development affecting both hands, with progressive functional decline in the left hand. She had reduced grip strength compared to age-matched individuals. Fine motor coordination was limited, particularly for tasks requiring precision and sustained grip. Her feet had structural differences that affected her walking tolerance. Her skin was chronically dry and sensitive due to ectodermal involvement, which required consistent skin-care measures. Dental abnormalities were present and managed through routine dental care. Mild ocular dryness was an additional feature.

The immediate reason for hospitalization was not the syndrome itself but the progressive functional deterioration of her left hand that had reached a point where surgical reconstruction was considered appropriate. The goal of the procedure was to improve specific structural and functional aspects of the left hand, not to correct the underlying genetic condition.

Simran was admitted for a planned reconstructive procedure on her left hand. The surgery was elective and scheduled in advance, which allowed for appropriate preoperative preparation and planning. The specific surgical details are not documented in this case review, but the general intent was to improve the structural configuration and functional capacity of the left hand.

She remained in the hospital for 6 days following the procedure. During this time, the hospital team systematically monitored several parameters. The surgical site was inspected regularly for signs of bleeding, infection, or early wound separation. Pain levels were assessed and managed with prescribed analgesic medication. Swelling around the operative area was monitored, as postoperative edema is expected and must be distinguished from problematic inflammatory changes. Circulation to the fingers was checked to ensure that the surgical repair had not compromised blood flow. Hand movement was observed within the limits permitted by the surgical team. Wound healing was tracked from the immediate postoperative period through to the time of discharge.

Before discharge, the surgical team confirmed that the wound was stable, pain was adequately controlled with oral medication, and there were no signs of infection or circulatory compromise. The discharge plan was then prepared with specific instructions covering several areas.

The discharge prescription included pain medication to be taken as directed. Surgical wound care instructions were provided, with clear guidance that dressings should not be removed or altered unless specifically directed by the treating team. Hand protection instructions emphasized activity restrictions, including avoidance of heavy lifting, forceful gripping, and unapproved movements. A referral for physiotherapy and hand rehabilitation was included, with the understanding that exercise would begin only after surgical clearance at the appropriate time. A surgical follow-up appointment was scheduled.