case_images: PMC6051112_01
case_images: Onchodystrophy of toenails.
case_images: CRIM2018-9409732.001.jpg
case_images: PMC6051112_01_CRIM2018-9409732.001.jpg
case_images: fig1
case_images: 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.
case_images: (a) Hyperpigmentation of hands before therapy. (b) Resolution of hyperpigmentation 9 months following therapy with infliximab.
case_images: CRIM2018-9409732.002.jpg
case_images: PMC6051112_01_CRIM2018-9409732.002.jpg
case_images: fig2
case_images: 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)).
case_images: Abdominal CT on admission demonstrating hypertrophic gastric folds.
case_images: CRIM2018-9409732.003.jpg
case_images: PMC6051112_01_CRIM2018-9409732.003.jpg
case_images: fig3
case_images: 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.
case_images: CRIM2018-9409732.004.jpg
case_images: PMC6051112_01_CRIM2018-9409732.004.jpg
case_images: fig4
case_images: 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)).
case_images: (a, b) Irregular glands with focal cystic dilation, severe edema of the lamina propria, and a sprinkling of eosinophil leukocytes.
case_images: CRIM2018-9409732.005.jpg
case_images: PMC6051112_01_CRIM2018-9409732.005.jpg
case_images: fig5
case_images: The lamina propria was widely expanded by edema with an infiltrate of eosinophils and mononuclear cells (Figures 5(a) and 5(b)).