Photo Quiz

Diffuse, Erythematous, Scaly Eruption

 


FREE PREVIEW. AAFP members and paid subscribers: Log in to get free access. All others: Purchase online access.


FREE PREVIEW. Purchase online access to read the full version of this article.

Am Fam Physician. 2015 Dec 15;92(12):1105-1106.

A 52-year-old male smoker presented with a mildly pruritic rash that began three months earlier on his back and spread to his scalp, trunk, and extremities, including the palms and soles. He had a history of alcoholic cirrhosis. He had no recent new exposures, including medications.

Physical examination revealed numerous well-circumscribed, erythematous, non-blanching plaques with adherent white scale involving approximately 70% of his body (Figures 1 and 2). His palms and soles displayed thick scale with fissures, and he had oil spots and onycholysis affecting several fingernails.


Figure 1.


Figure 2.

Question

Based on the patient's history and physical examination findings, which one of the following is the most likely diagnosis?

A. Cutaneous sarcoidosis.

B. Nummular eczema.

C. Plaque psoriasis.

D. Subacute cutaneous lupus erythematosus.

E. Tinea corporis.

Address correspondence to Mukti Kulkarni, MD, at mukti.kulkarni@umassmemorial.org. Reprints are not available from the authors.

Author disclosure: No relevant financial affiliations.

REFERENCES

show all references

1. Raychaudhuri SK, Maverakis E, Raychaudhuri SP. Diagnosis and classification of psoriasis. Autoimmune Rev. 2014;13(4–5):490–495....

2. Langley RG, Krueger GG, Griffiths CE. Psoriasis: epidemiology, clinical features, and quality of life. Ann Rheum Dis. 2005;64(suppl 2):ii18–ii23.

3. Menter A, Gottlieb A, Feldman SR, et al. Guidelines for the management of psoriasis and psoriatic arthritis: section 1. J Am Acad Dermatol. 2008;58:826–850.

4. Weigle N, McBane S. Psoriasis. Am Fam Physician. 2013;87(9):626–633.

5. James WD, Elston DM, Berger TG, Andrews GC, eds. Andrews' Diseases of the Skin: Clinical Dermatology. London, UK: Saunders/Elsevier; 2011.

6. Hsu S, Le EH, Khoshevis MR. Differential diagnosis of annular lesions. Am Fam Physician. 2001;64(2):289–296.

This series is coordinated by John E. Delzell, Jr., MD, MSPH, Assistant Medical Editor.

A collection of Photo Quiz published in AFP is available at http://www.aafp.org/afp/photoquiz.

Previously published Photo Quizzes are now featured in a mobile app. Get more information at http://www.aafp.org/afp/apps.

The editors of AFP welcome submissions for Photo Quiz. Guidelines for preparing and submitting a Photo Quiz manuscript can be found in the Authors' Guide at http://www.aafp.org/afp/photoquizinfo. To be considered for publication, submissions must meet these guidelines. E-mail submissions to afpphoto@aafp.org.



 

Copyright © 2015 by the American Academy of Family Physicians.
This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact afpserv@aafp.org for copyright questions and/or permission requests.

Want to use this article elsewhere? Get Permissions

CME Quiz

More in AFP


Editor's Collections


Related Content


More in Pubmed

MOST RECENT ISSUE


Sep 15, 2016

Access the latest issue of American Family Physician

Read the Issue


Email Alerts

Don't miss a single issue. Sign up for the free AFP email table of contents.

Sign Up Now

Navigate this Article