A 72-year-old man with a history of arterial hypertension, diabetes mellitus and hypercholesterolemia presented to our outpatient clinic with a 6-month history of induration in both forearms and proximal muscles of both legs. He also referred weight loss, paresthesias and numbness in both hands, and he had been recently diagnosed with bilateral carpal tunnel syndrome. Physical examination revealed a marked induration of the skin affecting extremities and abdominal wall. Elevation of the arms revealed the presence of grooves in the inner forearms (Fig. 1, white arrows).
