Acquired Ichthyosis Triggered by an Osseous Hemangiopericytoma: A Case Report and Review of the Literature
A 34-year-old woman presented to our Department with a 2-month history of a widespread, scaling, skin eruption. She also complained of a 7-kg weight loss over the last 2 months as well as fatigue and low back pain. On physical examination, she had generalized xerosis with large rhomboidal scales covering most of her body and scalp, painful stomatitis and palmar and plantar hyperkeratosis (fig. ). Bilateral ectropion due to eyelid involvement was present. There was no personal or family history of ichthyosis. A skin biopsy was performed, which confirmed the clinical diagnosis of AI by revealing hyperorthokeratosis and an absence of granular layers (fig. ). However, her past medical history was significant for osseous HP, for which she had successfully undergone tumor embolization, followed by a total tumor resection 2 years ago. Based on her past medical history and the current signs, a possible recurrence of HP was suspected, and therefore, an abdominal computed tomography (CT) scan was recommended. The CT scan revealed a multilobular tumor mass in the minor pelvis, infiltrating the sacrum and perirectal space and spreading to the lower lumbar muscles (HP recurrence) (fig. ). The presence of multiple liver metastases was also reported. Intensive topical emollients were prescribed for the AI, and the patient was referred to the Oncology Department. Treatment with paclitaxel at a dose of 80 mg/m2 at days 1, 8 and 15, followed by 1 week of rest and repeated every 4 weeks. Unfortunately, despite the chemotherapy, no improvement of either the tumor mass and metastases or the AI was observed over the following 3 months. On the contrary, at that point, the patient's general condition started to deteriorate rapidly. The patient passed away 6 months after her initial presentation.