Scleroderma; Lichen Sclerosis et Atrophicus? Presented by George M. Lewis, M.D.
History.—
A white man, aged 30, first noticed difficulty in closing his hands 4 years ago. Gradually, areas of hardness were noticed, affecting the extremities and the trunk in increasing numbers. The process has continued to date. He has never had white fingers, but cold weather causes pain in his fingers and toes. He has had a number of spontaneous ulcerations of the back.Previous treatment has included steroids, Camoquin, chloroquine, antihistamines, and chelating agents. After the use of a chelating agent there was marked hyperpigmentation.
Examination.—
A more or less generalized eruption consisted of various-sized areas of sclerosis. There were a number of hypertrophic scars on the back. The skin generally showed marked hyperpigmentation.There were also areas of atropic skin suggesting lichen atrophicus. The patient also had alopecia areata.
Discussion
Dr. Orlando Canzares: I think the patient