Hyperextension of each elbow beyond 10 degrees. Hyperextension of each knee beyond 10 degrees. Forward flexion of the trunk so that the palms of the hands rest easily on the floor. The skin has a soft velvety consistency, similar to wet chamois leather, it extends easily and snaps back after release. Lacerations of the skin may follow even mild trauma.
Wound healing is poor and 'cigarette paper' scars are common.
Skin can be discoloured over the elbows, knees and shins and haematoma may be present. Hyperextensibility The degree of skin extensibility varies from patient to patient, and between various sites of the body, the skin of the ventral aspect of the forearm is lifted at a point midway between the elbow and the wrist joint. The distance to which this skin fold can be stretched without causing discomfort is measured in centimetres. Scarring A score of one was given for each of 5 bony points that bore more than 2 scars which were over 2 centimetres in length. The areas which are assessed are both elbows, both knees, and the forehead.