• The skin over the neck, axillae and groin is smooth and elastic (Fig. 133.2). It can be stretched and, when released, it returns immediately to its normal position. Late in the disease it becomes lax, wrinkled and hangs in folds.

• Look at bony prominences for bruising, haematomas and gaping wounds. Wounds heal forming tissue-paper or papyraceous or ‘cigarette-paper’ scars. Haematomas heal forming pseudotumours or nodules.

• Kyphoscoliosis

• Hypermobile joints (Fig. 133.3).

• Tell the examiner that you would like to examine the following: