The punch biopsy specimen from the dorsal aspect of the toe demonstrated acanthosis, papillomatosis, and hyperkeratosis. The collagen bundles were normal in appearance, but the dermis was markedly thickened for the anatomical site. Because of the clinical and microscopic findings, the patient was diagnosed as having Proteus syndrome.
Cohen and Hayden1 identified the initial features of Proteus syndrome in 1979, but it was not recognized as a distinct disorder until Wiedemann et al2 coined the name Proteus syndrome in 1983. The syndrome is characterized by hamartomatous and multifocal overgrowths that may affect any tissue and structure of the body. The hallmark of the disease is its tremendous phenotypic variability, the nature of which also defies delineation of the syndrome.
Hypertrophic Toe in a 44-Year-Old Man. Arch Dermatol. 2001;137(2):219-224. doi: