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To the Editor.—
The usual cutaneous feature of scleroderma, including sclerosis, edema, atrophy, telangiectasia, pigmentary changes and calcinosis, are well known. One feature that is not well documented is the occasional presence of lymphangiectasis. We have observed this cutaneous feature in three patients with systemic scleroderma. In all, the skin of the hands and forearm was very thickened and "hidebound," with a sharp line of demarcation from normal skin. The lesions developed as multiple, small papules with a digitate surface (Fig 1). Histologically, there was dilatation of the lymphatic channels in the upper dermis (Fig 2). Presumably, this is due to obstruction by the sclerosing process.Fig 1.—Forearm of patient with lymphangiectasis showing lesions as small papules with a digitate surface.Fig 2.—Dilation of the lymphatic channels in the upper dermis.
Tuffanelli DL. Lymphangiectasis Due to Scleroderma. Arch Dermatol. 1975;111(9):1216. doi:10.1001/archderm.1975.01630210132028