Touraine-Soulente-Golé Syndrome: A Rare Case Report and Review of the Literature
A 27-year-old male came with complaints of repetitive wrinkling and thickening of skin on face and scalp along with broadening of hands since 8 years ago. He also complained of increased oiliness on the face. This healthy Indian male with normal physique and intelligence level was the 1st son of non-consanguineous parents, his elder brother was 31. He has a 3 years old son and a 5 years old daughter. Family history was unremarkable. History of joint pains, oral and genital ulceration, hoarseness of voice, epistaxis and sensory loss was denied. No similar history was found in the family. Physical examinations revealed scalp skin was folded, giving appearance of peculiarity cutis verticis gyrata (), whereas the hair growth appeared normal. Eyebrows appeared dense. Skin over face was thickened, non-pinchable, greasy to touch and folded, giving appearance of leonine faces (). Follicular openings were prominent and so were the video-dermoscopy. In addition, clubbing of fingers and toes was presented along with broadening of hands and fingers (). Cutaneous examination over the rest of his body including mucosae was normal. Laboratory investigations included growth hormone assay, thyroid profile, and Venereal Diseases Research Laboratory Assay and were found to be within normal limits. Erythrocyte sedimentation rate was elevated (45 mm in 1st hour). Serum calcium, alkaline phosphatase and other biochemical tests were also within normal limits. Smears for lepra bacilli were negative. Radiological investigations included radio-graphs' of skull, which were normal including sella turcica. Long bones of legs showed minimal periosteal reaction along the shaft () and his feet showed evidence of cortical erosions and tufting ends of terminal phalanges. Histopathological examination from skin behind ear lobule showed a hyperplastic epidermis and dermis (). On the basis of history, clinical features, radiological and lab findings, the diagnosis of TSG syndrome was formulated.