case_images: PMC5803940_01
case_images: Diffuse swelling of right lower limb extending from groin up to the mid leg. Multiple varicosities are visible on the surface
case_images: IDOJ-9-37-g001.jpg
case_images: PMC5803940_01_IDOJ-9-37-g001.jpg
case_images: F1
case_images: On physical examination, there was diffuse swelling of the right lower limb extending from the groin up to the mid leg [Figure 1].
case_images: (a) Multiple discrete, reddish-brown, telangiectatic papules involving the nasolabial furrows and cheeks. Dental pits and gingival fibromas are appreciable. (b) Skin-colored papules coalescing to form plaque and single hypopigmented patch visible on the left lateral trunk
case_images: IDOJ-9-37-g002.jpg
case_images: PMC5803940_01_IDOJ-9-37-g002.jpg
case_images: F2
case_images: There were multiple firm, discrete, reddish-brown, telangiectatic papules on the face involving the nasolabial furrows and cheeks [Figure 2a]. Multiple ash leaf-shaped hypopigmented patches of variable sizes were seen on trunk [Figure 2b]. Soft, skin-colored papules were coalescing to form plaque on the left lateral trunk [Figure 2b]. On oral mucosal examination, dental pits and gingival fibromas were also seen [Figure 2a].
case_images: MRI of the right lower limb showing altered signal intensity involving the musculature of all compartments of the right thigh and leg suggestive of fatty infiltration
case_images: IDOJ-9-37-g003.jpg
case_images: PMC5803940_01_IDOJ-9-37-g003.jpg
case_images: F3
case_images: T2-weighted hyperintense) involving the musculature of all compartments of the right thigh and leg suggestive of fatty infiltration and multiple prominent, tortuous vessels suggestive of venous channels [Figure 3]. There was associated cortical thickening of right femur and tibia with anterior bowing deformity of femur.