PMC3934780_01
a Facial skin xerosis. b Large rhomboidal scales covering most of the body. c Dry skin with rhomboidal scales on the lower extremities. d Plantar hyperkeratosis.
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F1
On physical examination, she had generalized xerosis with large rhomboidal scales covering most of her body and scalp, painful stomatitis and palmar and plantar hyperkeratosis (fig. 1a-d).
a Hyperorthokeratosis, absence of granular layer and reduced rete-papilla pattern (HE, x40). b Osseous HP.
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F2
A skin biopsy was performed, which confirmed the clinical diagnosis of AI by revealing hyperorthokeratosis and an absence of granular layers (fig. 2a). The CT scan revealed a multilobular tumor mass in the minor pelvis, infiltrating the sacrum and perirectal space and spreading to the lower lumbar muscles (HP recurrence) (fig. 2b).