case19

CREST syndrome-A clinical and dermoscopic perspective

Alin Laurentiu Tatu

Faculty of Medicine and Pharmacy, University ,,Dunarea de Jos “, Galati, Romania

 

Corresponding author: Alin Laurentiu Tatu, MD PhD, E-mail: dralin_tatu@yahoo.com

 

Submission: 19.03.2017; Acceptance: 28.03.2017

DOI: 10.7241/ourd.2017e.8

How to cite this article: Tatu AL. CREST syndrome-A clinical and dermoscopic perspective. Our Dermatol Online. 2017;8(1e):e9.


A 59-year-old woman was diagnosed with scleroderma. Five years later she developed swallowing difficulties, constipation, weight loss, arrhythmias and from rheumatology she was referred to dermatology for the skin changes. On examination there were skin nodules on the fingers from calcinosis, Reynaud’s phenomenon, sclerodactyly with ulcerations of the distal fingers (Figs. 1a and 1b) with a hardened skin on fingers, severe tightening of the facial skin with difficulties to open the mouth, dry mouth and eyes.

Figure 1a: Sclerodactily, small ulcerations, crusts and digital telangiectasias.
Figure 1b: Small ulceration and crusts on the finger. (Dermoscopy).

 

On the  face and palms there were vissible telangiectasias (Figs. 2a and 2b) and loss of subcutaneous fat on her, trunk, upper limbs and face with  movement limitations (Fig. 3). We diagnosed her condition as CREST syndrome. The skin treatment was empirically indicated: gentle skin cleansers, moisturizers, regular streching exercise with physical therapist, quit smoking, gloves wearing, laser surgery  for telangiectasias. The dermatology and rheumatology follow –up was recommended.

Figure 2a: Facial and labial telangiectasias, perioral hardened skin with limitations of mouth opening.
Figure 2b: Digital telangiectasias (Dermoscopy).
Figure 3: Scapular atrophy and movement limitations.

 

Notes

Source of Support: Nil,

Conflict of Interest: None declared.


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