This 51-year-old woman presented with a 2-year history of chronic hand eczema that would partially respond to topical corticosteroids, only to recur. She denied any new exposure history. She had not had the condition in the past.
What explains this recurrent rash?
A. Contact dermatitis
B. Atopic dermatitis
C. Psoriasis
D. Lichen planus
E. Dyshidrosis
What diagnostic measure could provide an important clue?
A. Patch testing
B. Examination of the fingernails
C. Examination of the elbows and knees
D. Examination of the feet
E. Potassium hydroxide (KOH) preparation
To learn the answers, go to page 2
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Answer: Psoriasis
The patient had psoriasis, which originally had been diagnosed and treated as eczema.
All of the approaches aforementioned—patch testing, KOH prep testing, and examination of the fingernails, elbows, knees, and feet—are important maneuvers in making the correct diagnosis of psoriasis. The fingernails will show possible signs of psoriasis or lichen planus. Tinea pedis of the feet could result in dyshidrosis and yield KOH prep test results that are positive for fungal infection.
On closer physical examination, this patient also had involvement of her elbows, which allowed the diagnosis of psoriasis to be made. The well-demarcated lesions on the palms support the diagnosis. Nevertheless, it is important to remember that patients can have overlapping diagnoses.
While there are many safe and effective treatments for psoriasis, patients with extensive involvement often require systemic therapy. This is especially true for difficult-to-treat areas such as the hands. This patient was started on topical corticosteroids alternating with calcipotriene.
This article was originally published in Consultant. 2017;57(8):477-478.
Dr Kaplan is a clinical assistant professor of dermatology at the University of Missouri–Kansas City School of Medicine in Kansas City, Missouri, and at the University of Kansas School of Medicine in Kansas City, Kansas. He practices adult and pediatric dermatology in Overland Park, Kansas. He is on The Dermatologist Editorial Board and is also the Series Editor of Dermclinic in Consultant.
This 51-year-old woman presented with a 2-year history of chronic hand eczema that would partially respond to topical corticosteroids, only to recur. She denied any new exposure history. She had not had the condition in the past.
What explains this recurrent rash?
A. Contact dermatitis
B. Atopic dermatitis
C. Psoriasis
D. Lichen planus
E. Dyshidrosis
What diagnostic measure could provide an important clue?
A. Patch testing
B. Examination of the fingernails
C. Examination of the elbows and knees
D. Examination of the feet
E. Potassium hydroxide (KOH) preparation
Answer: Psoriasis
The patient had psoriasis, which originally had been diagnosed and treated as eczema.
All of the approaches aforementioned—patch testing, KOH prep testing, and examination of the fingernails, elbows, knees, and feet—are important maneuvers in making the correct diagnosis of psoriasis. The fingernails will show possible signs of psoriasis or lichen planus. Tinea pedis of the feet could result in dyshidrosis and yield KOH prep test results that are positive for fungal infection.
On closer physical examination, this patient also had involvement of her elbows, which allowed the diagnosis of psoriasis to be made. The well-demarcated lesions on the palms support the diagnosis. Nevertheless, it is important to remember that patients can have overlapping diagnoses.
While there are many safe and effective treatments for psoriasis, patients with extensive involvement often require systemic therapy. This is especially true for difficult-to-treat areas such as the hands. This patient was started on topical corticosteroids alternating with calcipotriene.
This article was originally published in Consultant. 2017;57(8):477-478.
Dr Kaplan is a clinical assistant professor of dermatology at the University of Missouri–Kansas City School of Medicine in Kansas City, Missouri, and at the University of Kansas School of Medicine in Kansas City, Kansas. He practices adult and pediatric dermatology in Overland Park, Kansas. He is on The Dermatologist Editorial Board and is also the Series Editor of Dermclinic in Consultant.
This 51-year-old woman presented with a 2-year history of chronic hand eczema that would partially respond to topical corticosteroids, only to recur. She denied any new exposure history. She had not had the condition in the past.
What explains this recurrent rash?
A. Contact dermatitis
B. Atopic dermatitis
C. Psoriasis
D. Lichen planus
E. Dyshidrosis
What diagnostic measure could provide an important clue?
A. Patch testing
B. Examination of the fingernails
C. Examination of the elbows and knees
D. Examination of the feet
E. Potassium hydroxide (KOH) preparation
,
This 51-year-old woman presented with a 2-year history of chronic hand eczema that would partially respond to topical corticosteroids, only to recur. She denied any new exposure history. She had not had the condition in the past.
What explains this recurrent rash?
A. Contact dermatitis
B. Atopic dermatitis
C. Psoriasis
D. Lichen planus
E. Dyshidrosis
What diagnostic measure could provide an important clue?
A. Patch testing
B. Examination of the fingernails
C. Examination of the elbows and knees
D. Examination of the feet
E. Potassium hydroxide (KOH) preparation
To learn the answers, go to page 2
{{pagebreak}}
Answer: Psoriasis
The patient had psoriasis, which originally had been diagnosed and treated as eczema.
All of the approaches aforementioned—patch testing, KOH prep testing, and examination of the fingernails, elbows, knees, and feet—are important maneuvers in making the correct diagnosis of psoriasis. The fingernails will show possible signs of psoriasis or lichen planus. Tinea pedis of the feet could result in dyshidrosis and yield KOH prep test results that are positive for fungal infection.
On closer physical examination, this patient also had involvement of her elbows, which allowed the diagnosis of psoriasis to be made. The well-demarcated lesions on the palms support the diagnosis. Nevertheless, it is important to remember that patients can have overlapping diagnoses.
While there are many safe and effective treatments for psoriasis, patients with extensive involvement often require systemic therapy. This is especially true for difficult-to-treat areas such as the hands. This patient was started on topical corticosteroids alternating with calcipotriene.
This article was originally published in Consultant. 2017;57(8):477-478.
Dr Kaplan is a clinical assistant professor of dermatology at the University of Missouri–Kansas City School of Medicine in Kansas City, Missouri, and at the University of Kansas School of Medicine in Kansas City, Kansas. He practices adult and pediatric dermatology in Overland Park, Kansas. He is on The Dermatologist Editorial Board and is also the Series Editor of Dermclinic in Consultant.
This 51-year-old woman presented with a 2-year history of chronic hand eczema that would partially respond to topical corticosteroids, only to recur. She denied any new exposure history. She had not had the condition in the past.
What explains this recurrent rash?
A. Contact dermatitis
B. Atopic dermatitis
C. Psoriasis
D. Lichen planus
E. Dyshidrosis
What diagnostic measure could provide an important clue?
A. Patch testing
B. Examination of the fingernails
C. Examination of the elbows and knees
D. Examination of the feet
E. Potassium hydroxide (KOH) preparation
Answer: Psoriasis
The patient had psoriasis, which originally had been diagnosed and treated as eczema.
All of the approaches aforementioned—patch testing, KOH prep testing, and examination of the fingernails, elbows, knees, and feet—are important maneuvers in making the correct diagnosis of psoriasis. The fingernails will show possible signs of psoriasis or lichen planus. Tinea pedis of the feet could result in dyshidrosis and yield KOH prep test results that are positive for fungal infection.
On closer physical examination, this patient also had involvement of her elbows, which allowed the diagnosis of psoriasis to be made. The well-demarcated lesions on the palms support the diagnosis. Nevertheless, it is important to remember that patients can have overlapping diagnoses.
While there are many safe and effective treatments for psoriasis, patients with extensive involvement often require systemic therapy. This is especially true for difficult-to-treat areas such as the hands. This patient was started on topical corticosteroids alternating with calcipotriene.
This article was originally published in Consultant. 2017;57(8):477-478.
Dr Kaplan is a clinical assistant professor of dermatology at the University of Missouri–Kansas City School of Medicine in Kansas City, Missouri, and at the University of Kansas School of Medicine in Kansas City, Kansas. He practices adult and pediatric dermatology in Overland Park, Kansas. He is on The Dermatologist Editorial Board and is also the Series Editor of Dermclinic in Consultant.
Answer: Psoriasis
The patient had psoriasis, which originally had been diagnosed and treated as eczema.
All of the approaches aforementioned—patch testing, KOH prep testing, and examination of the fingernails, elbows, knees, and feet—are important maneuvers in making the correct diagnosis of psoriasis. The fingernails will show possible signs of psoriasis or lichen planus. Tinea pedis of the feet could result in dyshidrosis and yield KOH prep test results that are positive for fungal infection.
On closer physical examination, this patient also had involvement of her elbows, which allowed the diagnosis of psoriasis to be made. The well-demarcated lesions on the palms support the diagnosis. Nevertheless, it is important to remember that patients can have overlapping diagnoses.
While there are many safe and effective treatments for psoriasis, patients with extensive involvement often require systemic therapy. This is especially true for difficult-to-treat areas such as the hands. This patient was started on topical corticosteroids alternating with calcipotriene.
This article was originally published in Consultant. 2017;57(8):477-478.
Dr Kaplan is a clinical assistant professor of dermatology at the University of Missouri–Kansas City School of Medicine in Kansas City, Missouri, and at the University of Kansas School of Medicine in Kansas City, Kansas. He practices adult and pediatric dermatology in Overland Park, Kansas. He is on The Dermatologist Editorial Board and is also the Series Editor of Dermclinic in Consultant.
