Green Sweating Spots on Hands and Feet: Unusual Expression of Hyperbilirubinemia
Authors: Alessandro Di Stefani, Luca Bianchi, Augusto Orlandi, Sergio Chimenti
Journal: Annals of Internal Medicine (2006)

Letters7 November 2006Green Sweating Spots on Hands and Feet: Unusual Expression of HyperbilirubinemiaAlessandro Di Stefani, MD, Luca Bianchi, MD, Augusto Orlandi, MD, and Sergio Chimenti, MDAlessandro Di Stefani, MDFrom Tor Vergata University, Rome, Italy., Luca Bianchi, MDFrom Tor Vergata University, Rome, Italy., Augusto Orlandi, MDFrom Tor Vergata University, Rome, Italy., and Sergio Chimenti, MDFrom Tor Vergata University, Rome, Italy.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-145-9-200611070-00024 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Liver disease may cause cutaneous manifestations, including jaundice, purpurae, diffuse erythema, spider nevi, telangiectasia, atrophy, hyperpigmentation, gynecomastia, thin hair, and white nails.Objective: To describe a patient with cholestatic hyperbilirubinemia who presented with green discoloration of the hands and feet.Case Report: A 56-year-old man, hospitalized for recurrent fever, latent jaundice, and epigastric pain, progressively developed macules on his hands and feet. The macules were deep green; were partly coalescing; and were preferentially located on the volar and lateral sides of the fingers, palms, and soles (Figure, A). He also had mild keratoderma in the affected areas. Examination with ...References1. Hall MJ. A staining reaction for bilirubin in sections of tissue. Am J Clin Pathol. 1960;34:313-6. [PMID: 13710798] CrossrefMedlineGoogle Scholar2. Kanzaki T, Tsuda J. Bile pigment deposition at sweat pores of patients with liver disease. J Am Acad Dermatol. 1992;26:655-6. [PMID: 1597560] CrossrefMedlineGoogle Scholar3. Allegue F, Hermo JA, Fachal C, Alfonsín N. Localized green pigmentation in a patient with hyperbilirubinemia. J Am Acad Dermatol. 1996;35:108-9. [PMID: 8682944] CrossrefMedlineGoogle Scholar4. Fung MA, LeBoit PE, Maibach HI. Coalescing green and yellow papules on the feet. Arch Dermatol. 2000;136:113, 116. [PMID: 10632213] CrossrefMedlineGoogle Scholar5. MacSween RM, Millard LG. A green man. Arch Dermatol. 2000;136:115, 118. [PMID: 10632216] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Alessandro Di Stefani, MD; Luca Bianchi, MD; Augusto Orlandi, MD; Sergio Chimenti, MDAffiliations: From Tor Vergata University, Rome, Italy.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byCromhidrosis ecrina por hiperbilirrubinemia secundaria a terapia antirretroviralGreen sweat: an atypical finding in drug-induced liver diseaseThe significance of isolated elevation of serum aminotransferases in infants and young children 7 November 2006Volume 145, Issue 9Page: 710-711KeywordsAtrophyBilirubinBiopsyErythemaExcretionLiver diseasesStainingSweatSweat glands ePublished: 7 November 2006 Issue Published: 7 November 2006 Copyright & PermissionsCopyright © 2006 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...