Pityriasis rotunda associated with hepatocellular carcinoma

Abstract

Pityriasis rotunda associated with hepatocellular carcinomaDear Editor, A 67-year-old man, with a past medical history of primary biliary cirrhosis, presented to our clinic with a 1-year history of an asymptomatic eruption. On examination, there were hyperpigmented, scaly, circular, fine plaques over the abdomen, back, arms, buttocks and legs. There was a sharp demarcation between the involved area and the normal surrounding skin (Figure 1a,b). No previous history of inflammatory or allergic dermatosis was reported. On dermoscopy, white polygonal streaks were observed with a homogeneous brown background (Figure 1c). A skin biopsy from his right arm showed epidermal atrophy, decreased granular layer contrasting with hyperkeratosis, and a mild perivascular lymphocytic infiltrate in the superficial dermis (Figure 1d). Hence, the diagnosis of PR was made. We performed laboratory studies, including complete blood count, serum chemistries and tumour markers that were unremarkable. Computed tomography imaging of the abdomen revealed cirrhosis degeneration into hepatocellular carcinoma (HCC). The patient was then referred to the gastrointestinal Department for further investigation.