Fig. 1: Frequent and/or remarkable features in patients with classical-like Ehlers–Danlos syndrome (clEDS).

a Skin hyperextensibility. b Easy bruising and spontaneous ecchymoses in a child with TN-X deficiency; a suspicion on nonaccidental injury was raised. c Wrinkled skin with deformation of thumbs and fingers due to joint hypermobility and repetitive dislocations. d Fat pads on soles of feet and piezogenic pedal papules. e Foot deformations with hallux valgus and over and underlapping toes in P3 at the age of 62 years. f Broad forefeet with short toes. g Foot deformations with hallux valgus and over and underlapping toes in P1 at the age of 55 years. h Skin wrinkling on soles of feet. i Subcutaneous spheroids on elbow. j Clinical photographs of patients P3 and P6 showing no specific dysmorphic features but sagging of the skin in 62-year-old P3 and to a milder degree in 68-year-old P6.