EDEMA and induration of the skin that clinically resemble the dermal lesions of progressive systemic sclerosis have been reported in diverse disorders (Table).1-3 We describe a patient with scleroderma-like skin changes that preceded other findings of tumor-associated hypertrophic osteoarthropathy, resolving rapidly after lobectomy for lung carcinoma.
Report of a Case
A 39-year-old woman was seen in January 1977 with a three-week history of bilateral ankle pain that was neither aggravated by weight bearing nor relieved by rest or elevation. She denied trauma, Raynaud's phenomenon, dermatitis, skin or hair changes, alopecia, previous serositis, oral ulcers, ocular or gastrointestinal symptoms, fever, weight loss, dyspnea and cough, morning stiffness, and family history of inflammatory rheumatic disease. A total abdominal hysterectomy and bilateral salpingo-oophorectomy for menometrorrhagia were performed seven years earlier; a 45 pack-year history of cigarette smoking was related.Physical examination showed a healthy woman with tenderness over the anterior tibiotalar joint