<P> GD type I (non-neuropathic) is the most common and least severe form of the disease . Symptoms may begin early in life or in adulthood and mainly affect the liver, spleen, and bone . Enlarged liver and grossly enlarged spleen (together hepatosplenomegaly) are common; the spleen can rupture and cause additional complications . Skeletal weakness and bone disease may be extensive . Spleen enlargement and bone marrow replacement cause anemia, thrombocytopenia, and leukopenia . The brain and nervous system are not affected pathologically, but lung and, rarely, kidney impairment may occur . Patients in this group usually bruise easily (due to low levels of platelets) and experience fatigue due to low numbers of red blood cells . Depending on disease onset and severity, type I patients may live well into adulthood . The range and severity of symptoms can vary dramatically between patients . </P> <P> GD type II (acute infantile neuropathic) typically begins within 6 months of birth and has an incidence rate around one 1 in 100,000 live births . Symptoms include an enlarged liver and spleen, extensive and progressive brain damage, eye movement disorders, spasticity, seizures, limb rigidity, and a poor ability to suck and swallow . Affected children usually die by age two . </P> <P> GD type III (chronic neuropathic) can begin at any time in childhood or even in adulthood, and occurs in about one in 100,000 live births . It is characterized by slowly progressive, but milder neurologic symptoms compared to the acute or type II version . Major symptoms include an enlarged spleen and / or liver, seizures, poor coordination, skeletal irregularities, eye movement disorders, blood disorders including anemia, and respiratory problems . Patients often live into their early teen years and adulthood . </P> <Ul> <Li> Painless hepatomegaly and splenomegaly: the size of the spleen can be 1500 - 3000 ml, as opposed to the normal size of 50 - 200 ml . Splenomegaly may decrease the affected individual's capacity for eating by exerting pressure on the stomach . While painless, enlargement of spleen increases the risk of splenic rupture . </Li> <Li> Hypersplenism and pancytopenia, the rapid and premature destruction of blood cells, leads to anemia, neutropenia, leukopenia, and thrombocytopenia (with an increased risk of infection and bleeding). </Li> <Li> Cirrhosis of the liver is rare . </Li> <Li> Severe pain associated with joints and bones occurs, frequently presenting in hips and knees . </Li> <Li> Neurological symptoms occur only in some types of Gaucher's (see below): <Ul> <Li> Type I: impaired olfaction and cognition </Li> <Li> Type II: serious convulsions, hypertonia, mental retardation, and apnea </Li> <Li> Type III: muscle twitches known as myoclonus, convulsions, dementia, and ocular muscle apraxia </Li> <Li> Parkinson's disease is recognized as being more common in Gaucher's disease patients and their heterozygous carrier relatives . </Li> </Ul> </Li> <Li> Osteoporosis: 75% of patients develop visible bony abnormalities due to the accumulated glucosylceramide . A deformity of the distal femur in the shape of an Erlenmeyer flask is commonly described (aseptic necrosis of the femur joint). </Li> <Li> Yellowish - brown skin pigmentation </Li> </Ul>

The wrinkled region was caused by the formation of