Figure 3.

Individual 4 at the Ages of 6 and 14 Years

She is 6 years of age in (A) and (B) and 14 years of age in (C) and (D). The views of her limbs at these two time points illustrate the severity of the progression in this individual. She had short hands and feet with small distal phalanges. There were star-shaped scar-like lesions on her palms and horizontal linear bands of thickened skin on the dorsum of her hands and tops of her feet. Dermatoglyphics were absent, and there was thickened skin at the ends of the digits. She had linear areas of thickened skin and pseudopodia of the feet. Her skin was dry, thickened, and hyperkeratotic, but the vascular pattern was normal.