Monday, March 5, 2007

Derm round 23

A 70 years old man was referred to the clinic for further management of multiple pruritic rashes over the body and lower limbs of two years duration.
The lesions over the body and lower limbs appeared well-demarcated erythematous rashes with scaling and excoriation. In addition, he has generalized skin dryness (xerosis).
I would have dismissed the case as 'another chronic eczema', until I find these lesions over the anterior chest.
A large ring-like lesion with central paling. There was reduced pin-prick sensation.
He also has this hand appearance, fixed flexion deformities of the right 4th and 5th fingers; suggesting of an ulna nerve lesion. The ulna nerve was thick on palpation. In addition, he has sparce eyebrows.
Slit-skin smears confirmed the diagnosis.
(Pic taken with my SE750)