Sunday, January 05, 2020

70 yo man with scaly plams and soles

A 70 year-old pediatric colleague from the Florida Keys sent us the following:

“I’ve been doing battle for the past few years with a rash that seemed to appear first on front of my right knee that seemed scaly, responded to clobetasol. Then, it decided to affect soles of both feet and palms of both hands,.  These were dry, thickened and split.  The fissures can be quite tender. Flares come and go over few months span.  I have noticed no pitting of my nails however I’ve either developed hypertrophic great toenails or fungus.  Topical antifungals were of no avail. The rash actually flared badly enough this last year that my great toe nails fell off. Of course they are growing back with similar thickening. I have not done KOH of any scrapings.  Topical clobetasol and moisturizing are my treatment at this time.



I am curious of your thoughts.  Please share these photos with colleagues  The were were taken after a two hour dive session.

Clinical Images:


Addendum: One of the commentators asked what medications this man is on.  The only one is tamsulosin.  Another asked about saturation diving.  No history of that.

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