SUMMARY
Two patients are described who had delayed reactions with eczematous plaques to subcutaneous injections of heparin. Subcutaneous challenge with high and low molecular weight heparin compounds were positive in both patients. Patch and intradermal tests with heparin were positive in one subject. Histological and immunohistochemical studies indicated that it was a type IV allergic reaction.
Keratosis palmoplantaris progrediens et transgrediens (Greither’s disease) was first described by Greither in 1952. The inheritance pattern is autosomal dominant with variable expression. The clinical manifestation is characterized by diffuse palmoplantar keratoderma associated with hyperhidrosis and progressive extension of keratoderma to the dorsum of the hands and feet. In addition, hyperkeratotic plaques may occur on the elbows and knees. We describe a 44-year-old patient with typical features of Greither’s disease. Immunohistologic and ultrastructural investigations are presented.
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