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(a) Leather-like texture, absence of fingerprints and transverse palmar crease with increased fine wrinkling of hands (IV:4). (b) Knuckle pads on the dorsal aspect of the hands (IV:4). (c) Contractures of digits and palmoplantar keratoderma (II:3). (d) Nail dystrophy (II:3). (e) Hyperpigmented macules on the dorsal aspect of hand (III:6). (f) Pedigree of the family. The arrow denotes the proband.
