Clinical Images: Diffuse systemic sclerosis, skin bleaching, and telangiectasia

This Afro-Caribbean female was diagnosed with diffuse systemic sclerosis in 2004 at age 15 when she presented with Raynaud's, sclerodactyly and diffuse sclerodermatous skin with pigmentary changes. Images A and B at time of diagnosis revealed focal areas of depigmentation at the inner corner of both eyes, patchy hyperpigmentation of the upper eyelids and hyperpigmentation with loss of wrinkling of the skin of the neck.