Cholesterol crystal embolization: skin manifestation, gastrointestinal and central nervous symptom treated with corticosteroid.
Cholesterol crystal embolization (CCE) is characterized by tissue ischemia secondary to occlusion of small arteries. It may occur spontaneously but more often follows radiological interventional procedures or vascular surgery. This systemic disease affects multiple organs, including skin, kidney, brain, eye, and gastrointestinal tract. We reported a Japanese male CCE patient with cutaneous manifestations of livedo reticularis, diarrhea, clouding of consciousness, and acute renal failure. Histopathological examination demonstrated multiple biconvex clefts in a vessel of the subcutis. Corticosteroid administration improved his consciousness, diarrhea and skin lesions. Awareness of the skin manifestations of CCE is essential for dermatologists to make an early diagnosis and prescribe appropriate treatment.
Motegi
Sei-ichiro
S
Department of Dermatology, Gunma University Graduate School of Medicine, Gunma 371-8511, Japan.
Abe
Masatoshi
M
Shimizu
Akira
A
Tamura
Atsushi
A
Hatori
Takashi
T
Nakano
Akihiko
A
Hasegawa
Akira
A
Kurabayashi
Masahiko
M
Ishikawa
Osamu
O
D000284:Administration, Oral; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D003460:Crystallization; D003937:Diagnosis, Differential; D017700:Embolism, Cholesterol / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000150:complications; D011239:Prednisolone / Q000627:therapeutic use; D051437:Renal Insufficiency / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D017445:Skin Diseases, Vascular / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D013577:Syndrome
D000893:Anti-Inflammatory Agents; D011239:Prednisolone