PMC5664252_01
The patient presented with thickening and hyperpigmentation of both axillae.
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fig1
Upon examination, she presented with extensive hyperkeratosis and scaling of the skin especially on palms and soles and hyperpigmented skin flexures (Figures 1()-3()).
Brown scaly hyperpigmentation could also be seen on the nape of the neck.
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fig2
Upon examination, she presented with extensive hyperkeratosis and scaling of the skin especially on palms and soles and hyperpigmented skin flexures (Figures 1()-3()).
Palmoplantar keratoderma was also present.
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fig3
Upon examination, she presented with extensive hyperkeratosis and scaling of the skin especially on palms and soles and hyperpigmented skin flexures (Figures 1()-3()).
The deep white matter of the centrum semiovale bilateral demonstrates high signal intensity changes at Flair axial MR imaging.
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fig4
Other metabolites like N-acetyl aspartate (NAA), choline (Cho), and creatine (Cr) were within normal limits (Figures 4()-6()).
Flair axial MR image of the brain showing high-intensity lesions in the deep white matter of the frontal lobes and milder-intensity lesions in the deep white matter of the posterior parietal lobes and the corpus callosum.
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fig5
Other metabolites like N-acetyl aspartate (NAA), choline (Cho), and creatine (Cr) were within normal limits (Figures 4()-6()).
Magnetic resonance spectroscopy (MRS) showed moderate increase of lipid and myoinositol levels. Other metabolites like N-acetyl aspartate (NAA), choline (Cho), and creatine (Cr) were within normal limits.
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fig6
Other metabolites like N-acetyl aspartate (NAA), choline (Cho), and creatine (Cr) were within normal limits (Figures 4()-6()).