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  Indian J Med Microbiol
 

Figure 1: (A-C) Clinical photographs of face, both hands and feet showing normal facial skin, bulbous enlargement of fingers and toes as well as enlargement of both ankles. Multiple skeletal radiographs (a-d) show extensive and symmetrical periosteal reaction (thin arrow) seen in the bones of bilateral forearms and legs, small bones of hands and feet. The periosteal reaction involved diaphysis, metaphysis as well as epiphysis of long bones. There was bulbous appearance (outlined arrow) of tips of fingers and toes due to increased soft tissue in that region

Figure 1: (A-C) Clinical photographs of face, both hands and feet showing normal facial skin, bulbous enlargement of fingers and toes as well as enlargement of both ankles. Multiple skeletal radiographs (a-d) show extensive and symmetrical periosteal reaction (thin arrow) seen in the bones of bilateral forearms and legs, small bones of hands and feet. The periosteal reaction involved diaphysis, metaphysis as well as epiphysis of long bones. There was bulbous appearance (outlined arrow) of tips of fingers and toes due to increased soft tissue in that region