Similar
patches were seen on other portions of the face. Patches of
varying size and form, sharply limited by a kind of small,
peripheral "dike," sinuous but uninterrupted, of a color varying
from red to whitish-red, dirty white, and to a hue but little
different from that of the healthy skin. Similar patches were
seen on the right hand, and again on the back of the right hand
was a wide space, prolonged upward in the form of a broad band on
the posterior surface of the forearm to just below the olecranon,
where the skin was a little smoother and thinner than the
surrounding skin, and altogether bare of hairs. The disease was
noticed at the age of two, and gradually progressed. The patient
always enjoyed the most perfect health, but had contracted
syphilis three years before. A brother of the patient, aged
twenty-four, for sixteen years has had the same skin-affection as
this patient, on the back of the hand, and the sister and father
had noticed similar lesions.
Diffuse symmetric scleroderma, or hide-bound disease, is quite
rare, and presents itself in two phases: that of infiltration
(more properly called hypertrophy) and atrophy, caused by
shrinkage. The whole body may be involved, and each joint may be
fixed as the skin over it becomes rigid.
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