A man in his 60s presented with a 1-year history of dystrophic nails, doughy palms, and redundant skin on each side of the gluteal cleft. He also reported easy bruising with minor trauma. Physical examination showed trachyonychia (rough accentuated linear ridges) on 8 fingernails (Figure, A), thin and brittle toenails, diffuse nonscarring alopecia, and multiple purpuric patches on the forehead, scalp, chest, and arms. He had substantial laxity of the skin on finger pads (Figure, A), and both sides of the gluteal cleft revealed soft, nontender, rugated, skin-colored linear kissing plaques with no vesicles, bullae, ulcers, or erosions present.
Que SKT, Sloan B, Dadras SS. Trachyonychia, Cutis Laxa, and Easy Bruising of the Skin. JAMA Dermatol. 2014;150(12):1357-1358. doi:10.1001/jamadermatol.2014.2337