A Professional Networking Site for Doctors & Medical Students Worldwide

Karuturi Rounds 79 > What is this rash?

A 58 year old with type 2 Diabetes with a pruritic macular rash on the leg, on and off, this time for 2 weeks.

What is your diagnosis?

Image Credit :

Dr. Mahaveer Mukkamalla, MD

Family Physician

Belmont Community Health Center

Bellaire, OH, USA

Tags: dermatology, karuturi.rounds

▶ Reply to This

Replies to This Discussion

Permalink Reply by Adel ElKady on November 9, 2012 at 10:53pm

Necrobiosis Diabeticorum

▶ Reply

Permalink Reply by S.UMA DEVI on November 24, 2012 at 9:55pm

DRY ECZEMA

▶ Reply

Permalink Reply by Dr. Padmesh Jain on November 25, 2012 at 1:08am

from history appears more like Necrobiosis Diabeticorum

▶ Reply

Permalink Reply by Adevair Marques Filho on November 25, 2012 at 5:56am

Dermophaty diabetic

▶ Reply

Permalink Reply by RIZWAN AHMED on December 1, 2012 at 12:24pm

this is an elderly patient who is diabetic. the skin in general appears dry. and there is a excoriated coin like lesion in the centre. given his age and diabetes and the dryness of skin , i think it is asteatotic dermatitis. this kind of dermatitis starts with dryness of skin. dry skin is itchy. constant itching and breaking of skin leads to dermatitis.

dryness of skin can happen in old neglected individuals especially on legs. it can be aggravated by diuretics, statins, hypothyroidism etc.

▶ Reply

Permalink Reply by Subrahmanyam Karuturi on December 18, 2012 at 6:40pm

The correct answer is Dyshidrotic Eczema (Pompholyx).

Dyshidrotic Eczema (Pompholyx)

Dyshidrotic eczema is a form of dermatitis characterized by a pruritic vesicular eruption on the fingers, palms, and soles . Patients may be affected at any age, with women affected twice as often as men. The condition may be acute, intermittent, or chronic. Eruptions occur with varying severity and can be mild or debilitating. Before the formation of vesicles, patients describe itching or burning of the hands and feet. Small vesicles appear along the lateral aspects of the fingers or feet, palms, and soles. Lesions may persist for weeks and may be accompanied by erythema of the palms and soles.

Treatment of dyshidrotic eczema includes high-potency topical steroids and cold compresses for symptomatic relief of the burning sensation. Greasy emollients are helpful to moisturize, protect, and prevent fissures. If fissures do occur, cyanoacrylate (“superglue”) can be used to seal small cracks in the skin and decrease pain. Short courses of oral steroids may be used for acute flares.

Reference : Rakel: Textbook of Family Medicine, 8th ed.