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A Case for Diagnosis. Presented by Dr. Theodore Cornbleet and Dr. Alfred B. Falk (by invitation).
F. B., a white woman aged 45, states that two months ago she noticed for the first time a thickening of the skin of the small toe of her left foot, which was followed by a similar condition on the small toes of the right foot and, two weeks ago, by thickening of the skin of the right palm.The patient has had six pregnancies, the second and third resulting in spontaneous abortions at five months. She has three children living and well. Eight years ago she had high blood pressure and heart trouble and was treated medically for three years. During the past five years she has been feeling well. There is no history of the ingestion of heavy metals or drugs of any kind in the past few years.Examination reveals thickening