For the average healthy adult, the recommended maximum dose of acetaminophen during a 24-hour period is 4 grams (4000 mg) or eight extra-strength tablets. (Each extra-strength tablet contains 500 mg, while each regular strength tablet contains 325 mg.) Among children, the dose of acetaminophen is determined on the basis of each child's weight and age, explicitly stated in the package insert. If these guidelines for adults and children are followed, acetaminophen is safe and carries essentially no risk of liver injury. A person who drinks more than two alcoholic beverages per day, however, should not take more than 2 grams (2000 mg) of acetaminophen over 24 hours, as discussed below, since alcohol makes the liver susceptible to damage from lower doses of acetaminophen.
Treatment: If a pancreatic or liver tumor is identified and able to be surgically excised, the skin lesions may normalize for an extended period of time, but because these tumors metastasize (spread to other areas of the body) quickly, surgery is not curative. In cases of end stage liver disease, surgery is not possible, and the goal of therapy is to increase quality of life and decrease uncomfortable skin lesions with supportive care and addressing the nutritional abnormalities. Supportive care includes supplementing protein and necessary minerals and enzymes through the diet and oral supplements or by weekly intravenous amino acid infusions that are performed in the hospital on an outpatient basis until improvement in the skin is noted. Unfortunately, despite the supportive care, the disease will progress.