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51-Year-Old-Female with Asymptomatic Rash on Hands

Can you diagnose this case?

David L. Kaplan, MD

Signs and Symptoms

This 51-year-old woman presented for evaluation of an asymptomatic rash of 2 years’ duration on her hands. She had seen several physicians and had been given an original diagnosis of eczema, then psoriasis, then finally dermatomyositis. She now had come for another opinion.

What would you say about this patient’s hands?

Choose one to reveal diagnosis and discussion

Eczema
Psoriasis
Dermatomyositis
All 3 of the above
Contact dermatitis

Answer: Eczema

See the full case at Consultant360

A biopsy of the lesions on the woman’s hands confirmed the clinical impression of eczema. This patient had been washing her hands more often than she had been moisturizing them. She was also perimenopausal and had lost the protection of estrogen, resulting in more dryness, as well. The affected areas were more prone to trauma and rubbing, resulting in the clinical pattern. Changing her washing and moisturizing regimen proved beneficial.