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Pachydermoperiostosis Associated with Acanthosis-Nigricans-like Syndrome. Presented by Dr. Willard L. Marmelzat.
A. H., a 53-year-old white man, was well until approximately 18 months ago, when the following symptoms and findings began to develop:
Patient noted pruritus first in the lower extremities. It gradually progressed so that at times many areas of the body have been affected, though recently it seems to have abated.
The nail "moons" increased in size about a year ago, and increased cupping of the nails was originally noted. Subsequently leuconychia increased; the nails became more sharply convex and have dug into the skin at the lateral edges of the nail plate so that paronychiae are constantly present. Longitudinal ridging increased, and hardness and thickness have subsequently developed.
Bluish-gray pigmentation of the skin developed about the neck subsequent to the initial appearance of a powdery dryness. Dryness developed all over the body with the exception