p53
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A friend of mine has this lesion (see attachment), especially erupting after sun exposure. Could anyone help me and say what is this?
Attached Files:
skin-diagnosis.doc (778 KB, 68 downloads)
Edited by p53 on 03/20/06 - 06:24 AM
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| drvic
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could you please provide more details? like - a detailed history, duration of these lesions, distribution on the body, systemic features, examination findings, any tests done so far?
just by looking at a picture alone, i would not hazard a guess....
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| jon657
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Yes, I agree. Remember HISTORY is King and Physical is Queen.
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| p53
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OK. first of all, forgot to say that you can make picture bigger by zooming in. Now, here is the history provided by the patient (see attachment)
Attached Files:
skinsymptoms.XLS (9 KB, 25 downloads)
Edited by p53 on 03/19/06 - 09:28 PM
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| bobby
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hey p53, i am always scared to download attachments because of virus. why not post it directly to the forum?
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| p53
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I'm sorry, but you can't post pictures or graphs directly, so I have to make attachments. Although I'm sure there is no virus treat, I respect your security. Here is patient history, though not in graphical form:
1995-1996
Damp office: many mosquitoes
Used Tortoise Mosquito Coils
Rashes on back of hand and around elbows; aggravated by sun exposure; stopped using coils and symptoms disappeared
2000
working with sheep since 1998
small scab on back of neck in April; increased in size over next 2 months then disappeared, very itchy
2001-2004
Very itchy rashes on back of hands, back of neck and around elbows
Symptoms aggravated by sun exposure
Appearing every year around same time: Starting April to May until August to September
2005
Very itchy rashes only on back of hands
Very different in appearance from previous times: drying and forming scabs very quickly
Rashes not itchy all the time. Usually start to itch 2 to 3 hours after sun exposure;
tried Lamisil cream, Lanacane cream, Topical hydrocortisone; Sunblock SPF 45: nothing worked
Edited by p53 on 07/01/05 - 07:10 AM
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| Dan Ivanov
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I'd go with psoriasis, but not sure...
By the way, the attachments are virus-free, just checked that.
Dan
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| claudia_i
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Sorry to hear about your friend. I could't see the picture, though ... could you email it to me? Based on the symptoms and the fact that it is resistant to topical treatment I would go with psoriasis too. The only thing that is puzzling me is the sun reaction because sunlight is used as adjuvant in psoriasis treatment. Is anybody in his family suffering from similar symptoms? Any nail involvement? Any facial rash? Any long term medication like beta-blockers or aspirin use? All the best.
Edited by claudia_i on 03/19/06 - 11:14 PM
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| claudia_i
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It may be just a shot in the dark, but what about pseudoporphyria?
Edited by claudia_i on 03/19/06 - 10:50 PM
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| Rasul
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It might be aktinic keratosis-lesions can disappear in winter months and reappear on summer. They might be itchy, look like plaques, down the road lichenifications might occur. The lesions would be dry, scaly. Tx for some people would be just avoiding sun for few years.
It also might be less serious condition-polymorphous light eruption (appears after sun exposure, always in the same locations, supposed to disappear in few hours-days, but stays with some people till the end of season, disappears in winter, then appears again with the very next sun exposure).
Why don't you guys just do a biopsy?
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| Rasul
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Dear p53!
How old is the patient?
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| claudia_i
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Nice differential, Rasul! I totally forgot about actinic keratosis and PMLE.
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| p53
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claudia, attached picture is in the Word format. thanks, guys, for help, but this post is 9 months old
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