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- Original article -
Cholesterol Crystal Embolization: Skin Manifestation, Gastrointestinal and Central Nervous Symptom Treated with Corticosteroid
Sei-ichiro Motegi, Masatoshi Abe, Akira Shimizu, Atsushi Tamura, Takashi Hatori*, Akihiko Nakano*, Akira Hasegawa*, Masahiko Kurabayashi* and Osamu Ishikawa
Department of Dermatology, Gunma University Graduate School of Medicine, Gunma, Japan.
*Department of Medicine and Biological Science, Gunma University Graduate School of Medicine, Gunma, Japan.
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 administraton 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.
key words: cholesterol crystal embolization; livedo reticularis; renal failure; eosinophilia; corticosteroids
Received August 23, 2004; Accepted for publication November 30, 2004
Reprint requests to: Sei-ichiro Motegi, M.D., Ph. D., Department of Dermatology, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, Japan.
J Dermatol 32 (4): 295-298, 2005
Japanese Dermatological Association