Systemic sclerosis.This collagen disease is characterized by thickening of the dermis leading to sclerodactyly (tightened skin on the fingers) and often web-like furrows of the peri-oral skin, as in this example. Systemic manifestations include esophageal involvement and intestinal dysmotility, as well as hypertension with cardiac involvement and renal impairment.
Note that this patient also has a smooth tongue with loss of papillae, secondary to coincidental iron deficiency.
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