Clinical manifestations of scleromyxedema. (A-B) Patient 8: most severe facial papules (A) and sclerodactyly with joint contractures (B). (C) Patient 6: small waxy papules on the neck. (D) Patient 5: white ridges on neck. (E-F) Patient 4: before transplantation, with facial papules, glabellar thickening, and alopecia (E), and after transplantation (F), with resolution.