Scleromalacia perforans is an extremely rare disease. It's present designation was given in 1934, by van der Hoeve.1From its first description in 1893, by Holthouse, until 1951, only 19 cases had been reported.2Since then a cursory review of the literature reveals an additional 8 cases, making a total of 27. Walter Bauer and his associates at the arthritis clinic of the Massachusetts General Hospital, in their series of 296 patients with rheumatoid arthritis, found no case of scleromalacia perforans.3Of 465 cases of rheumatoid arthritis studied at The Johns Hopkins Hospital by Smith, only 1 patient suffered from scleromalacia perforans.4Microscopic evidence of scleromalacia is apparently more frequent. In a survey in 1943 by Fingerman and Andrus, 66 autopsies were reported on patients suffering from rheumatoid arthritis and scleromalacia was found microscopically in 3 cases.5 Clinical Course In 1951, Sorsby described the scleromalacia