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Scleredema. Presented by Dr. W. H. Guy and Dr. Frederick Amshel, Pittsburgh.
This girl, aged 8 years, one month following scarlatina had "hardening of the skin." She was referred to the Allegheny General Hospital by her family physician. On admission, seven months ago, the skin of the face, arms and trunk was hard and did not pit on pressure. The process began on the face and neck and spread slowly. The affected skin was waxy brown. There were tenderness and itching. The mouth could be opened with difficulty, the eyelids could not be retracted and motion of the arms was limited. The face appeared masklike. The patient had low grade fever for several weeks. There was mild nephritis, and a subacute inflammatory process was noted in the pharynx and the tonsils. The Wassermann and Kahn reactions of the blood were negative, and numerous blood counts were normal. The basal metabolism