Green palmar discoloration in a patient with primary sclerosis
cholangitis: eccrine chromhidrosis or pompholyx?
Bochra Bouchabou1,2 | Fatma Ben Farhat1,2 | Rym
Ennaifer 1,2 | Abderrahmen Ennakhli1,2 | Houda Ben
Nejma1,2
1Department of Gastroenterology, Mongi Slim Hospital, Tunis, Tunisia
2Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis,
Tunisia
Correspondence
Fatma Ben Farhat, Department of Gastroenterology, Mongi Slim Hospital,
Tunis, Tunisia. Email Fatmabf8@gmail.com
Abstract:
Background: Chromhidrosis is defined by the secretion of colored sweat.
As sweat can be produced by either eccrine or apocrine glands,
chromohidrosis can be divided into subtypes and can have multiple
locations through the body. In the other hand, pompholyx is a type of
eczema characterized by the development of palmar and plantar vesicles.
Case report: we report the case of a 33-year-old woman with
decompensated cirrhosis complicating Primary sclerosis cholangitis (PSC)
suffering from abnormal bilateral pigmentation on palms, which lasted
two weeks. On clinical examination, green desquamative papules were
observed on the two palms (Fig.1) and levels of total (34.4 mg/dl) and
direct (17 mg/dl) bilirubin were elevated. No specimen for histological
research was done because lesions were already desquamative. Bacterial
samples were done without any sign of fungic or bacterial
infection.Conclusion: The case that we report can be eccrine
chromhidrosis resembling the clinical features of pompholyx with
explanation of probable pathomechanism. The green color is attributable
to the switch from brown-colored bilirubin to green-colored biliverdin
by oxidative processes.