A 46-year-old man presented with a 20-year history of dry skin. Approximately 5 years earlier, he had begun noticing hair loss, starting with the eyebrows and eyelashes, which had progressed to involve his scalp and entire body. Three years before presentation, he noticed an absence of sweating except on his knuckles. Ulcerations, preceded by dry, erythematous skin, developed on his buttocks and extended to his trunk and extremities. He denied any other health problems, and a review of systems revealed no abnormalities.
Hoefer HF, Chen S, Duvic MA, Raimer SS. Alopecia, Hypohidrosis, and Ulcerations in a Man. Arch Dermatol. 2002;138(4):527-532. doi:10.1001/archderm.138.4.527