case_images: PMC5664252_01
case_images: The patient presented with thickening and hyperpigmentation of both axillae.
case_images: CRIPE2017-7981750.001.jpg
case_images: PMC5664252_01_CRIPE2017-7981750.001.jpg
case_images: fig1
case_images: Upon examination, she presented with extensive hyperkeratosis and scaling of the skin especially on palms and soles and hyperpigmented skin flexures (Figures 1()-3()).
case_images: Brown scaly hyperpigmentation could also be seen on the nape of the neck.
case_images: CRIPE2017-7981750.002.jpg
case_images: PMC5664252_01_CRIPE2017-7981750.002.jpg
case_images: fig2
case_images: Upon examination, she presented with extensive hyperkeratosis and scaling of the skin especially on palms and soles and hyperpigmented skin flexures (Figures 1()-3()).
case_images: Palmoplantar keratoderma was also present.
case_images: CRIPE2017-7981750.003.jpg
case_images: PMC5664252_01_CRIPE2017-7981750.003.jpg
case_images: fig3
case_images: Upon examination, she presented with extensive hyperkeratosis and scaling of the skin especially on palms and soles and hyperpigmented skin flexures (Figures 1()-3()).
case_images: The deep white matter of the centrum semiovale bilateral demonstrates high signal intensity changes at Flair axial MR imaging.
case_images: CRIPE2017-7981750.004.jpg
case_images: PMC5664252_01_CRIPE2017-7981750.004.jpg
case_images: fig4
case_images: Other metabolites like N-acetyl aspartate (NAA), choline (Cho), and creatine (Cr) were within normal limits (Figures 4()-6()).
case_images: 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.
case_images: CRIPE2017-7981750.005.jpg
case_images: PMC5664252_01_CRIPE2017-7981750.005.jpg
case_images: fig5
case_images: Other metabolites like N-acetyl aspartate (NAA), choline (Cho), and creatine (Cr) were within normal limits (Figures 4()-6()).
case_images: 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.
case_images: CRIPE2017-7981750.006.jpg
case_images: PMC5664252_01_CRIPE2017-7981750.006.jpg
case_images: fig6
case_images: Other metabolites like N-acetyl aspartate (NAA), choline (Cho), and creatine (Cr) were within normal limits (Figures 4()-6()).