The skin in amyotrophic lateral sclerosis.

It has been repeatedly noted, but never as yet fully explained, that patients with ALS do not develop bedsores even at the terminal stage. Furthermore, the skin of ALS patients feels supple, like tanned leather, and loses elasticity. When the skin is stretched, it returns only sluggishly to its original position. We termed this property of skin 'delayed return phenomenon (DRP)'; it is usually seen more than 2 1/2 years after the onset of symptoms. Though it is thought that phenomena such as DRP and the absence of bedsores are characteristic of this disease, little attention has been paid to these unique features in ALS patients. In this review we summarize recent developments in research on skin from ALS patients, which may give insight into the possible mechanisms and pathogenesis underlying this disorder.