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  Vol. 143 No. 11, November 2007 TABLE OF CONTENTS
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Brown and Black Scaly Patches on the Lower Leg—Diagnosis

Arch Dermatol. 2007;143(11):1441-1446.

Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Diagnosis: Black stasis dermatitis as a cutaneous marker of hemochromatosis

MICROSCOPIC AND LABORATORY FINDINGS AND CLINICAL COURSE

The histopathologic specimen demonstrated neovascularization with prominent small blood vessels in the papillary dermis and dermal fibrosis, consistent with a diagnosis of stasis dermatitis. Hemosiderin, demonstrated by Perls stain, was conspicuously present throughout the dermis, while increased melanin deposition in the basal layer was demonstrated by Fontana-Masson silver stain. As clinically suspected, hemosiderin deposition was considerably increased in tissue from the patient's left leg compared with the right.

His serum ferritin level was 448.1 ng/mL (reference range, 25-285 ng/mL) (to convert to picomoles per liter, multiply by 2.247); iron saturation, 59.8% (reference range, 20%-50%); and hemoglobin level, 14.9 g/dL (reference range, 14-18 g/dL) (to convert to grams per liter, multiply by 10). Testing for the HFE gene revealed a heterozygous Cys282Tyr mutation. Clinical and microscopic findings were consistent with a diagnosis of stasis dermatitis with black pigmentation in a patient with hemochromatosis. Therapeutic phlebotomies resulted in a rapid decrease of . . . [Full Text of this Article]

DISCUSSION







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