PMC8191564_01
Macroglossia and elfin features
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F1
Her general features included elfin facies, upturned nose, low-set ears, hypertelorism of the orbits, acanthosis nigricans, skin tags, hirsutism, and enlargement of the secondary sex organs [Figures 1 and 2]. Macroglossia was seen with enlarged filiform papillae and vertical furrows [Figure 1].
Marked acanthosis nigricans and hirsutism, distended abdomen
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F2
Her general features included elfin facies, upturned nose, low-set ears, hypertelorism of the orbits, acanthosis nigricans, skin tags, hirsutism, and enlargement of the secondary sex organs [Figures 1 and 2].
Rough skin (upper extermities)
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F3
Upper and lower extremities showed extreme skin roughness [Figures 3 and 4].
Rough skin (lower extremities)
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F4
Upper and lower extremities showed extreme skin roughness [Figures 3 and 4].
Crowding of teeth, hyperplastic gingiva
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F5
Her intraoral features included crowded and dysplastic dentition, narrow maxillary arch, anterior open bite, palatally placed 12 and 22, and hyperplastic gingival among visible features [Figure 5].
Postoperative picture, extraction of the offending teeth
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F6
Not only were the carious teeth extracted but also the palatally placed teeth 12 and 22 were subsequently removed in an attempt to relieve the crowding [Figure 6].