Stiff Skin Syndrome: A Diagnostic Challenge and the Role of Complementary Studies.

Stiff skin syndrome (SSS) is a rare pediatric sclerosing disorder characterized by progressive fibrosis and mobility restriction. We report a 10-year-old girl with progressive skin induration whose diagnosis was supported by histopathology and high-resolution skin ultrasound. Ultrasound demonstrated dermal thickening and prominent hypodermal fibrous septa, findings that correlated with the characteristic hypoinflammatory lattice arrangement seen on histology. This case highlights the diagnostic value of integrating advanced imaging and pathology to ensure accuracy and avoid treatment delays, particularly in resource-limited settings where genetic testing is unavailable.