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Segmental Stiff Skin Syndrome: A Rare Case Report from Indonesia

fibrillin fibrosis hardened skin joint contractures stiff skin syndrome

Authors

  • Hafidzah Nurmastuti Department of Dermatology and Venereology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta , Indonesia, Indonesia
  • Retno Danarti Department of Dermatology and Venereology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Indonesia
  • Radijanti Anggraheni Department of Dermatology and Venereology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia, Indonesia
  • Intan Arvianty Department of Dermatology and Venereology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia, Indonesia
  • Devi Artami Susetiati Department of Dermatology and Venereology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia, Indonesia
  • Niken Trisnowati
    nikentris@ugm.ac.id
    Department of Dermatology and Venereology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta , Indonesia, Indonesia
March 31, 2025

Background: This paper reports a segmental Stiff Skin Syndrome (SSS) case in a four-year-old girl.  SSS is a rare disease characterized by skin hardening and joint stiffness due to a mutation of the fibrillin-1 (FBN-1) gene encoding the fibrillin protein. The effective therapies for this disease are limited. Case Report: The patient presented with hardened skin and a limping gait.  Clinically, there were hard, hyperpigmented patches with hypertrichosis on the skin of the left femur and left gluteal. The left coxae and left genu joint were in fixed flexion, causing a limping gait. The SSS histology revealed thickened collagen fibers, trapping adipocytes between them, but no inflammatory cells.  The UV-A phototherapy and physiotherapy session resulted in a modest improvement. Discussion: This case's segmental SSS diagnosis was based on clinical and histological findings. Establishing a diagnosis of SSS is a challenge for clinicians because it can resemble other skin disorders, particularly sclerosing diseases. The recommended management for SSS remains limited. In this case, after the UV-A phototherapy and physiotherapy, complaints of hardened skin were said to soften.

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