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August 1970

Society Transactions

Arch Dermatol. 1970;102(2):228-232. doi:10.1001/archderm.1970.04000080100023

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Primary Biliary Cirrhosis. Presented by Anthony N. Domonkos, MD.  This 58-year-old woman has had unrelenting pruritus for the past eight years, the onset coinciding with menopause. Attempts at controlling pruritus with antihistamines, sedatives, and corticosteroids were unsuccessful. In 1965 she was hospitalized with a tentative diagnosis of dermatitis herpetiformis. Hepatomegaly and abnormal liver function tests (elevated alkaline phosphatase, serum glutamic oxaloacetic transaminase [SGOT] and serum glutamic pyruvic transaminase) were discovered during this hospitalization. A liver biopsy showed periportal fibrosis. In 1967 she was again hospitalized and despite three skin biopsies no definite diagnosis was established. She entertained suicidal thoughts as the result of the continuing pruritus.Numerous excoriated papules and patches were present, especially on the trunk. A diffuse mottled hyperpigmentation of the entire skin was most prominent on the face, chest, and back. The liver was enlarged to four fingerbreadths below the

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