Case for Diagnosis. Presented by Donald G. Lindsay, MD.
A 17-month male Caucasian has had numerous upper respiratory and gastrointestinal upsets: he has been underweight, irritable, and intelligent. First seen June 12, 1964, with apparent juvenile acanthosis nigricans and cradle cap. Later defects of plantar and palmar keratinization became evident, plus similar changes on knees and elbows; there was also typical flexural eczema.
Darkly pigmented velvety areas on neck, axillae, and groin resembling acanthosis nigricans; hyperkeratosis and fissuring of palms and soles. Xerotic, thickened, fissured knees and elbows, lichenified, excoriated dermatitis of antecubital and popliteal fossae. Skin very dry; hair growth sparse.
Other Significant Laboratory Findings:
Renal survey negative.
Treatment and Results:
Corticosteroids with occlusive dressings gave temporary, gratifying results. Other treatment—fatty diet, fluids, vitamin A, thyroid, grenz ray; tar ointments had no effect.
Dr. Lawrence M. Nelson:
There was nothing in the past history of his