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Feb 2012

Progressive Sclerodermoid Skin Changes —Quiz Case

Author Affiliations
 

SECTION EDITOR: MARY S. STONE, MD; ASSISTANT SECTION EDITORS: SOON BAHRAMI, MD; CARRIE ANN R. CUSACK, MD; SENAIT W. DYSON, MD; MOLLY A. HINSHAW, MD; ARNI K. KRISTJANSSON, MD

Arch Dermatol. 2012;148(2):247. doi:10.1001/archderm.148.2.247-c

A 47-year-old otherwise healthy Hispanic woman presented with a 3-month history of painful symmetric hardening of the skin on her thigh, which rapidly progressed to the buttocks and abdomen. She had initially presented to her gynecologist with excessive uterine bleeding. Laboratory testing showed profound anemia and thrombocytopenia. Findings of an extensive workup including analysis of autoimmune markers, thyroid studies, and urinalyses were unrevealing. Complete endoscopy; computed tomography scans of the chest, abdomen, and pelvis; and a bone scan showed no abnormalities. Bone marrow, liver, and skin biopsies were nondiagnostic. Her condition deteriorated, and she developed progressive fatigue, decreased mobility, and sclerodermoid skin changes that prompted presentation to our clinic.

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