QUIZ SECTION
769 Advances in dermatology and venereology
ActaDV Acta Dermato-Venereologica ActaDV
Brownish-grey, Papular Scaling Rash on the Trunk and Lower Limbs: A Quiz
Elena MARINELLO 1, Giulia BIOLO 1, Roberto SALMASO 2, Anna BELLONI FORTINA 2, Dennis LINDER 3 and Stefano PIASERICO 1
1
Dermatology Unit, 2 Pathology Unit, Padua University Hospital, Padua, Italy, 3 Section of Epidemiology and Biostatistics, University of Oslo, NO- 0316 Oslo, Norway. E-mail: michael. dennis. linder @ gmail. com
A 30-year-old man with Fitzpatrick skin type III / IV presented to our clinic with a moderately itchy rash on his back, shoulders and lower limbs. The symptoms had started approximately 15 years previously.
Skin examination revealed multiple, 1 – 2-mm, firm, hyperkeratotic, brownish-grey coloured papules symmetrically located on his trunk, shoulders and shins( Fig. 1). The lesions partly coalesced into large plaques on the surface of the shins, while disseminated maculo-papules were scattered on the trunk. Scratch marks were evident near the papules.
The patient reported that the lesions first developed on the pretibial part of the lower limbs, before appearing successively on other areas. The itch first presented together with the lesions on the lower limbs, before decreasing progressively in that area and reappearing in association with the recently-developed lesions on the back.
The patient’ s medical and family histories were unremarkable. Laboratory testing for complete blood count, IgE levels, renal hepatic and lipid profiles were within normal limits.
What is your diagnosis? See next page for answer.
Fig. 1. Multiple, hyperkeratotic, brownish-grey coloured macules and papules symmetrically located on:( a) trunk,( b) shoulders, and( c) shins, where they partly coalesced into large plaques.
This is an open access article under the CC BY-NC license. www. medicaljournals. se / acta Journal Compilation © 2017 Acta Dermato-Venereologica. doi: 10.2340 / 00015555-2635 Acta Derm Venereol 2017; 97: 769 – 771