Derm round 19

50 years old gentleman, presented to me with the above lesions over his hands and feet of one month duration. He gave history of washing the floor mat with concentrated bleach solution three days before he started developing such lesions. He also stepped on the mat as well.

Clinically, the lesions appeared well-defined, dried and scaly with cracks, on an erythematous base. There were also maculo-papular rashes over the body. There was no scalp involvement or nail changes. Fungal scrapping was negative.

Although from the history, it sounded like contact dermatitis, clinically, the lesions appeared more "psoriatic". Furthermore, the lesions were more extensive and involved other non-exposure sites (body).

Diagnosis?
?Allergic contact dermatitis.
?Psoriasiform dermatitis.

Anyway, I treated him as having contact dermatitis.