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Anthony J. Mancini, MD; Youn H. Kim, MD
Northwestern University–Children's Memorial Hospital, Chicago, Ill (Dr Mancini), and Stanford University School of Medicine, Palo Alto, Calif (Dr Kim)

Arch Dermatol. 1998;134:97-102.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

REPORT OF A CASE

A 51-year-old, previously healthy white man presented with a 1-year history of tightening of the skin about his hands, fingers, upper trunk area, and perioral region, first noted following an influenzalike illness. The skin tightening progressed to involve his ears, neck, back, arms, and thighs, and he began noting decreased grip strength and hand coordination as well as difficulty in swallowing. A review of the systems demonstrated dysphagia and weight loss. There was no history of tryptophan use or significant industrial chemical exposure.

The physical examination revealed a thin man in no distress. The skin examination revealed a generalized erythematous to violaceous hue with induration of the anterior aspect of the upper trunk area and arms (Figure 1), hands, thighs, neck, ears, and face. The maximal oral aperture was greatly decreased. Multiple flesh-colored to slightly yellow, 1- to 2-mm-diameter papules . . . [Full Text of this Article]

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