2011 Volume 121 Issue 5 Pages 869-874
A 62-year-old man visited the department of surgery at our hospital with weight loss, liver dysfunction, and an elevation of serum IgG levels, all of which developed in January of 2007. A solitary mass was present in the liver. Histological examination led to a diagnosis of IgG4-related sclerosing cholangitis. The patient began taking prednisolone (PSL: 40 mg/day) in May. When his symptoms improved, the PSL was tapered to 5 mg/day. Itchy eruptions appeared on the patient’s extremities in July of 2008 and spread despite topical application of a glucocorticoid. He presented with small, hyperkeratotic, red papules on the extremities and trunk and scaly erythemas on the scalp. A biopsy specimen showed hyperkeratosis, parakeratosis, acanthosis, and collections of neutrophils in the stratum corneum and stratum spinosum. The dermal papillaries were edematous, and there was a superficial perivascular infiltrate of lymphocytes and plasma cells. These histopathological findings resembled those of psoriasis. There were a few IgG4-positive plasma cells in the dermis, and IgG4 deposition was observed on the vessels in the papillary dermis. We suggest that these psoriasiform eruptions might have been associated with the IgG4-related systemic disease.
