Figure 1
From: The challenges of Proteus syndrome: diagnosis and management
The distinction of overgrowth in a patient with PS (a–c) from that of a patient with hemihyperplasia (d, e). Panel a shows an early CCTN. Note that the appearance of this lesion is distinct from that of wrinkling of normal sole tissue. Panels b and c are from a patient with more advanced PS demonstrates several features of the disorder. Panel b shows distorting overgrowth of the first and fifth digits (arrows) with loss of the normal architecture of the digits. The overgrowth in the patient with PS is associated with calcified tissue around the epiphyses that restricts movement at the affected joints. The overgrowth in the patient with hemihyperplasia (d, e) is described by as ‘ballooning’ overgrowth as it is not associated with distortion.
