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Follicular Eruption on Arms and Legs—Quiz Case
April W. Armstrong, MD;
Hedy G. Setyadi, MD;
Vincent Liu, MD;
John Strasswimmer, MD, PhD
Harvard Medical School, Boston, Massachusetts (Dr Armstrong); Baylor College of Medicine, Houston, Texas (Dr Setyadi); University of Iowa College of Medicine, Iowa City (Dr Liu); and private practice, Delray Beach, Florida (Dr Strasswimmer)
Arch Dermatol. 2008;144(11):1509-1514.
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REPORT OF A CASE
A 17-year-old boy with congenital absence of the intrahepatic bile ducts owing to Alagille syndrome presented with a pruritic eruption of 3 months' duration. He also reported a new problem, seeing "dark spots" at night. His medical therapy included bile acid–binding resins and supplementation of fat-soluble vitamins. His chronic jaundice was unchanged. Physical examination revealed jaundice and numerous 2- to 8-mm follicular, keratotic erythematous papules on the distal extensor surfaces of his arms and legs (Figure 1). His vitamin A level was 11 µg/dL (reference level, 26-72 µg/dL), and his β-carotene level was less than 2 µg/dL (reference level, 9-190 µg/dL). (To convert vitamin A and β-carotene to micromoles per liter, multiply by 0.0349 and 0.01863, respectively.) Treatment resolved his lesions and vision changes. A punch biopsy specimen was obtained from the forearm . . . [Full Text of this Article]
RELATED ARTICLE
Follicular Eruption on Arms and Legs—Diagnosis
Arch Dermatol. 2008;144(11):1509-1514.
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