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Naji A. Kulaylat, MD; Hassib H. Narchi, MD; Samih A. Baalbaki, MD; Walter W. Tunnessen Jr, MD
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Section Editor: Walter W. Tunnessen, MD

Arch Pediatr Adolesc Med. 1998;152(4):405-406. doi:10.1001/archpedi.152.4.405.
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A 13-YEAR-OLD boy, the offspring of first cousins, presented with long-standing, brown-black, hyperpigmented, velvety, hyperkeratotic plaques over both ankles, axillae, neck, and groin (Figure 1). His face was acromegaloid and he had a generalized paucity of subcutaneous fat (Figure 2). His muscles were prominent and his abdomen distended (Figure 3). In addition, he was hirsute and his genitalia were enlarged. A paternal uncle has had similar skin lesions since he was a child.




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