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August 27, 1904


Author Affiliations

Professor of Skin and Venereal Diseases in the Medico-Chirurgical Hospital. PHILADELPHIA.

JAMA. 1904;XLIII(9):587-592. doi:10.1001/jama.1904.92500090001a

History.  —A lad, 18 years of age, afflicted with peculiar, characteristic and unusual lesions on the hands, knees, posterior aspect of the thighs below the buttocks and on the eyelids, was brought by his father to the dermatologic clinic of the Medico-Chirurgical Hospital, was shown to the class on several occasions and made the subject of a clinical lecture.

Physical Examination.  —Small in stature, general lack of development. Greatest weight, 79; present weight, 67. Thin, with almost no subcutaneous fat. General appearance that of a boy of twelve. Face marked with lines, giving the appearance of old age. Skin pale, showing a general anemic condition; complexion yellowish, subicteroid. Tongue flabby and pallid.Chest narrow, scapulæ prominent; marked depression above and below clavicle.Circulation poor; pulse weak. Heart's action increased, apex beat displaced, diffuse; functional cardiac murmur.Liver enlarged, extending from fifth interspace to an