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Linear Scleroderma. Presented by R.I. Rudolph, MD, J.J. Leyden, MD.
A 13-year-old girl developed poikilodermatous areas on the left side of the chest and the forearm in 1969. Induration of these areas followed several months later. Over the next three years, she developed firm, hypopigmented, depressed areas in a linear fashion in the affected limb. A clawhand deformity ensued, with loss of function. Biopsy specimen was interpreted as morphea. Treatment with intralesional injection of triamcinolone acetonide (Kenalog) was of little value, but physical therapy in the hospital and at home has
Dr. Paul R. Gross: If that clawhand is due to ulnar nerve entrapment, I wonder if a neurosurgical procedure might not relieve it. It might not be caused by contracture of the skin, but rather by nerve compression.Dr. Matthew A. Olivo: A clawhand may result when scleroderma extends down deeply into the bone.Dr. James M. Flood
Greenbaum CH. PHILADELPHIA DERMATOLOGICAL SOCIETY. Arch Dermatol. 1975;111(7):920. doi:10.1001/archderm.1975.01630190110017