case_images: PMC9729983_01
case_images: (a) Diffuse hyperpigmentation with hypopigmentation around the chest, nose, and lips of the patient. (b) Ulcerations on patients' fingers. (c) Ulceration on the tip of the patient's fingers.
case_images: 10.1177_2050313X221141796-fig1.jpg
case_images: PMC9729983_01_10.1177_2050313X221141796-fig1.jpg
case_images: fig1-2050313X221141796
case_images: Her skin was thickened and hyperpigmented over the face, neck, bilateral arm, forearm, thigh, and leg (Figure 1); there was patchy hypopigmentation over her chest, nose, and lips (Figure 1). The tips of her fingers had punched out ulcerations that were tender to touch (Figure 1).
case_images: Axial contrast-enhanced computed tomography scan of chest indicating bilateral pleural effusion and pulmonary edema.
case_images: 10.1177_2050313X221141796-fig2.jpg
case_images: PMC9729983_01_10.1177_2050313X221141796-fig2.jpg
case_images: fig2-2050313X221141796
case_images: Supplemental oxygen was started, and an urgent contrast-enhanced computed tomography scan of the chest was done, which showed high-grade pulmonary edema and bilateral pleural effusion (Figure 2).