PMC4802534_01
Progressive deterioration of 20 years' duration. The patient in 1999, 2005, and 2013.
gr1.jpg
PMC4802534_01_gr1.jpg
fig1
The 2013 DWD episode. Note the filiform keratoderma.
gr2.jpg
PMC4802534_01_gr2.jpg
fig2
Fig 2). Furthermore, extreme cachexia and tachycardia were present (Fig 3).
DWD: giant comedons, 2005; cachexia and erythema, 2005; compared with 2013.
gr3.jpg
PMC4802534_01_gr3.jpg
fig3
Fig 2). Furthermore, extreme cachexia and tachycardia were present (Fig 3).
Skin biopsy photomicrograph shows evidence of keratotic plug, dyskeratosis, and corps ronds (arrows). (H&E stain, original magnification: x360).
gr4.jpg
PMC4802534_01_gr4.jpg
fig4
An additional skin biopsy obtained from the trunk found keratotic plugs, dyskeratosis, corps ronds, grains, and suprabasal clefts (Fig 4); Periodic acid-Schiff staining was negative.