Xanthoma striatum palmare

A 31-year-old woman presented with a 7-month history of dark-colour urine, pruritus and xanthoma striatum palmare. Physical examination revealed diffuse yellowish and irregular plaques deposited over her fingers and palmar creases (figure 1). Skin biopsy was performed, which revealed accumulation of foam cells in the dermis (figure 2, arrow). The patient's medical history and family history were unremarkable for other skin diseases or coronary heart disease but 3 years ago, the patient was diagnosed with drug-induced liver injury (DILI) after an episode of jaundice attributed to use of over-the-counter herbal medicine for a common cold. Laboratory biochemistry results were as follows: total cholesterol, 34.8 mmol/L; low-density lipoprotein cholesterol (LDL-c), 9.7 mmol/L; triglyceride, 2.32 mmol/L; alkaline phosphatase (ALP), 1383.0 U/L; -glutamyltransferase, 617.0 U/L; total and conjugated bilirubin (TB/DB), 44.3 and 28.5 µmol/L, respectively. Serum markers for viral hepatitis were negative. Antimitochondrial antibody M2 (AMA-M2 0.44 IU/mL) and immunoglobulin M (IgM, 271 mg/dL) were normal. Genetic...

Source: Gut - July 7, 2016 Category: Gastroenterology Authors: Tian, Q.-j., Zhao, X.-y. Tags: GUT Snapshot Editor ' s quiz: GI snapshot Source Type: research