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A Case for Diagnosis. Presented by Dr. White.
R. E., a white girl, aged 3 years, had had a condition of the skin since birth. It consisted of groups of hyperkeratotic areas, slightly pigmented, around the neck, axillae, feet and knees. Her general health had been excellent. There was one other child in the family, living and well. The condition was first thought to be juvenile acanthosis nigricans.
DISCUSSION
Dr. Knowles: I think that acanthosis nigricans is ruled out by the distribution, the palms and extensor surfaces being affected. I should make the diagnosis of ichthyosis hystrix.Dr. Schamberg: I agree with the diagnosis. The basal metabolic rate would probably show hypothyroidism. The child had almost a complete absence of perspiration, even during the hottest days of summer.Dr. Weidman: The distribution is not quite that of the more common expressions of ichthyosis, but seems better for erythroderma ichthyose congenitale.