Patients complain of a slow onset of asymptomatic or mildly pruritic papules, which may be localized or become generalized. These patients are otherwise healthy and without systemic symptoms. These patients present with more widespread progressive induration and decreased mobility of the face, fingers and extremities. Patients have also been noted to have cysts and urticarial lesions. These patients may complain of systemic symptoms such as dysphagia, weakness and symptoms resembling organic brain disease.
Papules often have a striking pattern of parallel ridges.
Patients with the generalized lichenoid form may have distortion of facial ridges and facial folds called leonine faces. These patients may have difficulty opening their mouths. Severe proximal muscle weakness, polyarthritis, and symptoms resembling organic brain disease occur. Some of the ophthalmologic symptoms include ectropion and corneal opacities. Few patients may develop myeloma or Waldenstr m macroglobulinemia.