case_images: PMC8191564_01
case_images: Macroglossia and elfin features
case_images: NJMS-12-100-g001.jpg
case_images: PMC8191564_01_NJMS-12-100-g001.jpg
case_images: F1
case_images: Her general features included elfin facies, upturned nose, low-set ears, hypertelorism of the orbits, acanthosis nigricans, skin tags, hirsutism, and enlargement of the secondary sex organs [Figures 1 and 2]. Macroglossia was seen with enlarged filiform papillae and vertical furrows [Figure 1].
case_images: Marked acanthosis nigricans and hirsutism, distended abdomen
case_images: NJMS-12-100-g002.jpg
case_images: PMC8191564_01_NJMS-12-100-g002.jpg
case_images: F2
case_images: Her general features included elfin facies, upturned nose, low-set ears, hypertelorism of the orbits, acanthosis nigricans, skin tags, hirsutism, and enlargement of the secondary sex organs [Figures 1 and 2].
case_images: Rough skin (upper extermities)
case_images: NJMS-12-100-g003.jpg
case_images: PMC8191564_01_NJMS-12-100-g003.jpg
case_images: F3
case_images: Upper and lower extremities showed extreme skin roughness [Figures 3 and 4].
case_images: Rough skin (lower extremities)
case_images: NJMS-12-100-g004.jpg
case_images: PMC8191564_01_NJMS-12-100-g004.jpg
case_images: F4
case_images: Upper and lower extremities showed extreme skin roughness [Figures 3 and 4].
case_images: Crowding of teeth, hyperplastic gingiva
case_images: NJMS-12-100-g005.jpg
case_images: PMC8191564_01_NJMS-12-100-g005.jpg
case_images: F5
case_images: Her intraoral features included crowded and dysplastic dentition, narrow maxillary arch, anterior open bite, palatally placed 12 and 22, and hyperplastic gingival among visible features [Figure 5].
case_images: Postoperative picture, extraction of the offending teeth
case_images: NJMS-12-100-g006.jpg
case_images: PMC8191564_01_NJMS-12-100-g006.jpg
case_images: F6
case_images: Not only were the carious teeth extracted but also the palatally placed teeth 12 and 22 were subsequently removed in an attempt to relieve the crowding [Figure 6].