Introduction Our knowledge of Fabry's disease, long made up of smatterings, has recently blossomed. Just prior to the onset of the 20th century Fabry described a 13-year-old German boy with a peculiar skin eruption characterized by small, dark purple lesions, which, though heavily concentrated in the area of the thighs and genitalia, were lightly scattered over most of the body.1,2 Proteinuria and puffy eyelids were present. Fabry proposed the name angiokeratoma corporis diffusum universale, and demonstrated vascular lesions, which appeared to be intraepidermal. He noted their wide distribution, in contrast to the localized angiokeratoma of Fordyce and Mibelli.3,4 Around the same time Anderson reported a similar case from England.5 During succeeding years occasional reports enriched the dermatologic literature, making manifest the fact apparent even in the first cases, that the disease involved more than just the skin, and Pompen and his colleagues, largely since the Second World