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What Syndrome Is This?

A 5-year-old Caucasian boy was referred for easy bruising and scarring after minor trauma. A history of poor wound healing and joint hyperextension was given. The child had undergone a previous evaluation for a possible bleeding disorder. Results were negative, however, a diagnosis of von Willebrand’s disease was considered. The patient was otherwise well, with a negative family history for similar problems. Physical examination revealed a well-developed, well-nourished young boy with hyperelastic skin (Fig. 1), bilateral thumb hyperextensibility (Fig. 2), and hypermobility of other joints. Significant bruising was noted on the lower extremities, and multiple dystrophic scars (Figs. 3 and 4) were evident on the knees and elbows. These scars appeared thin and atrophic with a papyraceous texture.