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JAMA Dermatology Clinicopathological Challenge
December 2014

Trachyonychia, Cutis Laxa, and Easy Bruising of the Skin

Author Affiliations
  • 1Department of Dermatology, University of Connecticut, Farmington

Copyright 2014 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

JAMA Dermatol. 2014;150(12):1357-1358. doi:10.1001/jamadermatol.2014.2337

A man in his 60s presented with a 1-year history of dystrophic nails, doughy palms, and redundant skin on each side of the gluteal cleft. He also reported easy bruising with minor trauma. Physical examination showed trachyonychia (rough accentuated linear ridges) on 8 fingernails (Figure, A), thin and brittle toenails, diffuse nonscarring alopecia, and multiple purpuric patches on the forehead, scalp, chest, and arms. He had substantial laxity of the skin on finger pads (Figure, A), and both sides of the gluteal cleft revealed soft, nontender, rugated, skin-colored linear kissing plaques with no vesicles, bullae, ulcers, or erosions present.