PMC4748190_01
Hyperpigmentation, hyperkeratosis, and leathery texture of hands with onycholysis, loss of lunulae, and melanonychia.
crj-03-086-g001.jpg
PMC4748190_01_crj-03-086-g001.jpg
F1
Examination revealed icterus, hyperpigmentation, hyperkeratosis, and leathery texture over affected hands with onyncholysis, loss of lunulae, melanonychia, and firm hepatosplenomegaly (Figure 1).
Liver histopathology showing portal tracts with mixed inflammatory infiltrates, brown-colored bile laden macrophages with portal fibrosis and hepatocytes, and aggregated cellular and canalicular brownish red-colored bile deposits (H&E staining, x20 magnification).
crj-03-086-g002.jpg
PMC4748190_01_crj-03-086-g002.jpg
F2
Liver histopathology revealed portal tracts with mixed inflammatory infiltrates and brown-colored bile-laden macrophages with portal fibrosis and hepatocytes with aggregated cellular and canalicular brownish red-colored bile deposits (Figure 2).
The tissue showed (A) red birefringence and clusters of brilliantly illuminated granules in polarized light at x20 magnification and (B) Maltese cross pattern (arrow) at x40 magnification.
crj-03-086-g003.jpg
PMC4748190_01_crj-03-086-g003.jpg
F3
Red birefringence and clusters of brilliantly illuminated granules in a Maltese cross pattern on polarized light were also visible (Figure 3).