case_images: PMC10911786_01
case_images: a Facial appearance of the patient. b Marked thickening of the scalp (cutis verticis gyrata). c-e Clubbing of the fingers and toes. f-h Radiograph of the ankles, hands, and feet showing extensive periostosis.
case_images: cde-2024-0016-0001-536550_F01.jpg
case_images: PMC10911786_01_cde-2024-0016-0001-536550_F01.jpg
case_images: F1
case_images: On examination, the patient had different pronouncedly shaped keloids on his forehead and face, among the largest being 7 cm x 2 cm in size located on the forehead (Fig. 1a). In addition, the skin folds in the scalp were gyrus-like (Fig. 1b). Clubbing of his fingers and toes (Fig. 1c-e) was observed. Moreover, there was a cystic region in the distal left ulna (Fig. 1f-h).
case_images: Patient after 5 months (a) and more than 1 year (b) of treatment.
case_images: cde-2024-0016-0001-536550_F02.jpg
case_images: PMC10911786_01_cde-2024-0016-0001-536550_F02.jpg
case_images: F2
case_images: Subsequently, he was injected with botulinum toxin type A once every 6 months (Fig. 2).
case_images: Microscopic evaluation of the excised skin of a PDP patient (hematoxylin-eosin, original magnification: x100). Arrows indicate dermal vasculature, lymphoid tissue cells, plasma cells, neutrophilic leukocytes, and fibrous tissue hyperplasia.
case_images: cde-2024-0016-0001-536550_F03.jpg
case_images: PMC10911786_01_cde-2024-0016-0001-536550_F03.jpg
case_images: F3
case_images: Some blood vessels were perpendicular to the epidermis (Fig. 3).