Slowly sclerosing skin

Case Presentation

A 24-YEAR-OLD woman presents with progressive hardening and tightness of the skin of her right lower limb (Figures 1, 2). She first noticed swelling and redness of the skin overlying the thigh while trekking across South America six months ago. Subsequently, the soft tissue changes extended down the entire leg and proximally towards the abdomen. The affected skin has become pale and shiny with loss of hair follicles and is firm (sclerotic) on palpation. The affected limb also shows significant muscle atrophy and