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To the Editor.—
I have recently seen several patients with chronic pulmonary emphysema who had systemic areas of hyperpigmentation of the skin on the anterior lower thighs. This apparently is the result of chronic intermittent irritation secondary to a rather characteristic dyspneic posture often assumed by these patients. The patient frequently leans forward, supporting the weight of his trunk by placing his hands or elbows on his thighs just above the knees.
Report of a Case.—
A 65-year-old man had had chronic pulmonary emphysema for at least nine years. During the past four years he had noticed periodic tenderness and redness of the skin superior to the knees bilaterally. He associated this with continually leaning forward while sitting in an attempt to relieve dyspnea. He would support his trunk at those times by resting his hands or elbows on his anterior thighs (Fig 1). Subsequently he noted that these intermittently
Dahl MV. EMPHYSEMA. Arch Dermatol. 1970;101(1):117. doi:10.1001/archderm.1970.04000010119030