Hard - laying down of excess collagen, calcium, uric acid or foreign material in the skin
Soft - Loss of collagen , elastic tissue,
Rough - Thickened epidermis
Smooth - Thinned epidermis or something infiltrating the upper dermis or epidermis eg mucin
Raised -
Sunken- Loss of collagen , elastic tissue or fat
Firm or Hard -
Collagen - Morphoea, Lichen sclerosus , Scleroderma, En Coup de Sabre , Parry Romberg , Sclerotic alopecia in porphyria or scalp malignancy
Mucin - Scleredema, Scleromyxedema
Calcium - Scleroderma, Dermatomyositis
Uric acid - Gout
Malignant cells - Carcinoma en cuirasse from breast
Generalised Skin Hardening - Scleroderma, Scleromyxedema , Generalised morphoea , Eosinophilic fasciitis , Nephrogenic systemic fibrosis, Sclerotic Graft versus Host , Exogenous toxic exposures - rapeseed oil, L Tryptophan , PVC , Bleomycin and Taxanes
Neonates - Stiff skin syndrome (buttocks) , Scleredema of newborn
