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Puffy hands and shiny skin in early systemic sclerosis

Puffy hands and shiny skin in early systemic sclerosis
(A) Diffusely puffy fingers are a common initial presentation.
(B) Shiny skin suggests impending skin thickening.
Reprinted with permission from Systemic Sclerosis/Scleroderma: A Treatable Multisystem Disease, October 15, 2008, Vol 78, No 8, American Family Physician. Copyright © 2008 American Academy of Family Physicians. All Rights Reserved.
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