Thursday, June 19, 2014

Generalized Dermatitis in an 85 yo Woman

85 year old woman with wide-spread dermatitis.

HPI:  This 85 yo woman has had an evolving dermatitis for four to five months.  It began around two years ago with some spots on her legs.  Initially treated with clobetasol oint and prednisone.  She did well, but it recurred on her legs and has spread over the past few months.  It is moderately pruritic.  Initially, she was using clobetasol ointment.  She saw another provider recently who preformed a biopssy and ]prescribed calcipotriene which has caused increased pruritus.  Her only medications are levothyroxine and bisoprolol-hydrochlorthiazide which she's been on for a few years.  She has been under significant life-stress over the past two months.

Past Medical History:  As a teenager, during World War II, the patient was sent to California from her home in Hawaii.  During this stressful period, she had an eczematous eruption on her extremities.

Exam:  There is a generalized dermatitis consisting of erythematous scaly patches,  It covers all body surfaces including the face.

Clinical Photos: (June 18, 2014)


Pathology:  We've asked for the path report.

Diagnosis: Eczematous eruption in an octogenarian.

1 comment:

  1. Thanks for posting this case history. The lesions appeared eczematous to me more than psoriasiform. Wet compress with moderately potent topical corticosteroids would be helpful. How long has she been on bisoprolol -HCT combination? If it is recent, I would suggest withhold hydrochlorothiazide as this may be the contributing factor in this patient


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