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About the Authors:
Jo Anne Lim
* E-mail: [email protected]
Affiliation: Department of Dermatology, Hospital Raja Perempuan Zainab II, Kota Bharu, Kelantan, Malaysia
ORCID http://orcid.org/0000-0002-6212-6624
Zulrusydi Ismail
Affiliation: Department of Dermatology, Hospital Raja Perempuan Zainab II, Kota Bharu, Kelantan, Malaysia
Che Noraini Ibrahim
Affiliation: Department of Dermatology, Hospital Raja Perempuan Zainab II, Kota Bharu, Kelantan, Malaysia
Soon Eu Chong
Affiliation: Cluster of Regenerative Medicine, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Penang, Malaysia
Wan Noor Hasbee Wan Abdullah
Affiliation: Department of Dermatology, Hospital Raja Perempuan Zainab II, Kota Bharu, Kelantan, MalaysiaCitation: Lim JA, Ismail Z, Ibrahim CN, Chong SE, Wan Abdullah WNH (2017) A misdiagnosed infection mimicking “tree man disease”. PLoS Negl Trop Dis 11(6): e0005543. https://doi.org/10.1371/journal.pntd.0005543
Editor: Joseph M. Vinetz, University of California San Diego School of Medicine, UNITED STATES
Published: June 15, 2017
Copyright: © 2017 Lim et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Funding: This publication was funded by the Advanced Medical and Dental Institute, Universiti Sains Malaysia (http://www.amdi.usm.my/). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests: The authors have declared that no competing interests exist.
Case description
A 10-year-old girl with Down syndrome in Malaysia presented with extensive and generalized hyperkeratotic papules and plaques on her entire body (Fig 1) over a 4-year period. There was mild itching with severe hand and foot deformity. She was socially withdrawn with poor self-esteem and poor hygiene. She was also malnourished and could neither feed herself nor walk due to the deformity of her extremities (Fig 2).
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Fig 1. Extensive generalized hyperkeratotic plaques over the hands and feet.
(A) Left hand palmar view. (B) Left foot plantar view. (C) Left foot medial view.
https://doi.org/10.1371/journal.pntd.0005543.g001
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Fig 2. The deformed crusted plaques over the lower extremities made her unable to walk.
https://doi.org/10.1371/journal.pntd.0005543.g002
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