PMC6051112_01
Onchodystrophy of toenails.
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The patient also noticed onycholysis in both his hands and feet (Figure 1), followed by hyperpigmentation of his hands (Figure 2), soles of his feet and legs, and abdomen. Nonscarring alopecia was seen on the scalp, dystrophic nail changes were identified in both the hands (Figure 1) and feet, skin hyperpigmentation was noted primarily involving the palms (Figure 2), dorsal aspects of fingers, face, and limbs, as well as sexual pattern hair loss of the abdomen, groin, and axillary hair.
(a) Hyperpigmentation of hands before therapy. (b) Resolution of hyperpigmentation 9 months following therapy with infliximab.
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The patient also noticed onycholysis in both his hands and feet (Figure 1), followed by hyperpigmentation of his hands (Figure 2), soles of his feet and legs, and abdomen. Nonscarring alopecia was seen on the scalp, dystrophic nail changes were identified in both the hands (Figure 1) and feet, skin hyperpigmentation was noted primarily involving the palms (Figure 2), dorsal aspects of fingers, face, and limbs, as well as sexual pattern hair loss of the abdomen, groin, and axillary hair. Hyperpigmentation was globally improved (Figure 2(b)).
Abdominal CT on admission demonstrating hypertrophic gastric folds.
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Endoscopic findings of the upper gastrointestinal tract at the initial diagnosis. (a) The stomach revealing mucosal edema and hypertrophic gastric villi and (b) multiple semipedunculated gastric polyps.
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Upper endoscopy demonstrated florid gastric and duodenal polyposis, with thickening of gastric folds and "carpet-like" semipedunculated gastric and duodenal polyps ranging from 5 mm to 20 mm (Figures 4(a) and 4(b)).
(a, b) Irregular glands with focal cystic dilation, severe edema of the lamina propria, and a sprinkling of eosinophil leukocytes.
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The lamina propria was widely expanded by edema with an infiltrate of eosinophils and mononuclear cells (Figures 5(a) and 5(b)).