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Both patients presented with skin atrophy, hypochromic and hyperchromic areas with multiple telangiectasias (poikiloderma), and freckles predominantly in photo-exposed areas, as well as conjunctivitis and mild bilateral ectropion of the lower eyelid (right-hand image)

Intake visitcomprehensive neurobehavioral and neuromedical characterization Inclusion/exclusion criteria Participants had an intake visit to determine if they met inclusion/exclusion criteria (see Supplemental Information for details)

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In the District of Columbia nearly 2 in every 100 people used smokeless tobacco some days at the time of the survey