title: Cholesterol crystal embolization: skin manifestation, gastrointestinal and central nervous symptom treated with corticosteroid.
abstract: 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.
authors.affiliation: Department of Dermatology, Gunma University Graduate School of Medicine, Gunma 371-8511, Japan.
authors.forename: Sei-ichiro
authors.initials: S
authors.lastname: Motegi
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Abe
authors.forename: Akira
authors.initials: A
authors.lastname: Shimizu
authors.forename: Atsushi
authors.initials: A
authors.lastname: Tamura
authors.forename: Takashi
authors.initials: T
authors.lastname: Hatori
authors.forename: Akihiko
authors.initials: A
authors.lastname: Nakano
authors.forename: Akira
authors.initials: A
authors.lastname: Hasegawa
authors.forename: Masahiko
authors.initials: M
authors.lastname: Kurabayashi
authors.forename: Osamu
authors.initials: O
authors.lastname: Ishikawa
mesh_terms: 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
chemical_list: D000893:Anti-Inflammatory Agents; D011239:Prednisolone