Skin fragility and abnormal liver function tests
- aHull Royal Infirmary, Hull HU3 2JZ, UK Department of Gastroenterology, bDepartment of Pathology
- M Dakkak
- Accepted 3 December 1998
A 53-year-old man, a worker in a plastic factory, presented with a 12-month history of a non-itchy skin rash on the dorsum of both hands, associated with increased skin fragility and tendency to recurrent scar formation. The biochemical profile revealed an isolated elevation of serum alanine aminotransferase 55 IU/l (normal 5–36 IU/l). Clinical examination did not reveal any stigmata of chronic liver disease. He denied any history of jaundice, blood transfusions, intravenous drug use or family history of skin or liver disease. His alcohol intake was in the range of three bottles of wine a week. Hepatitis B surface antigen and hepatitis C antibodies (ELISA) were not detected. Serum copper, caeruloplasmin and alpha-1-antitrypsin levels were normal. No serum auto-antibodies were detected. Subsequently, a liver biopsy was performed (figure).
- What does the liver biopsy show ?
- What is the underlying skin disorder ?
- How is the condition treated ?
The figure is a high-power view of a portal tract with the adjacent hepatic parenchyma. The striking feature is the presence …