Phenytoin dependent fibrosis in polyfibromatosis syndrome

We have followed up the evolution of a polyfibromatosis syndrome in a 20-year-old male treated with diphenylhydantoin for epileptic convulsions. The main symptoms were attributable to fibrosis of the adventitial dermis associated with camptodactyly, knuckle pads, tendinous calcification, osseous hypoplasia of the face, scoliosis with thoracic deformation, and osteolytic changes of wrists, hands and feet. Quantitative variations of the mechanical properties of skin measured in vivo suggested a reversible fibrosing action of diphenylhydantoïn in a genetically predisposed patient.