September 2021 - Case of the Month
A 24-year-old woman presented with a several year history of evolving 'lumps' especially on the central chest. The lady had mild facial acne and was otherwise well.
A 42 year old man presented with a relatively short history of an itchy rash that started on his legs, then spread to his arms, and less so his trunk. He was otherwise well with no previous personal or family history of skin problems. No contacts were itchy. He took no prescribed or over-the-counter medications, and there was no relevant social history.
There were scattered erythematous patches on the aforementioned areas. There were no nail, scalp or oral changes.
What is the diagnosis?
The diagnosis is discoid eczema.
The main differential diagnosis is that of psoriasis. The differentiating features of these two conditions can include:
Discoid eczema
- There may be a past or personal family history of atopic conditions
- Itch is likely to be moderate, sometimes more severe
- Lesions tend to be lighter red, with a border that fades gradually at the periphery, and there is often surface exudate / crust as opposed to scale
- Often no significant nail involvement
Plaque psoriasis
- There may be a family history of psoriasis
- Itch may be absent or moderate
- Commonly affected sites include the extensor surfaces of the limbs, natal cleft, umbilicus, scalp (especially around the hairline), ears
- Lesions are often a deeper red, with a very distinct border, and white surface scale
Discoid eczema usually settles well with emollients and the short-term use of a potent topical steroid. For more information please refer to the chapter on discoid eczema.
A 24-year-old woman presented with a several year history of evolving 'lumps' especially on the central chest. The lady had mild facial acne and was otherwise well.
A 52 year old man presented with a one year history of skin lesions predominantly on his hands, ears and scalp. He was also complaining of painful swollen fingers associated with morning stiffness. There was no family history of skin or joint problem...
A 72 year old man was referred with a rash, predominantly on the legs. The patient was systemically well and the lesions were only mildly symptomatic. The lesions presented as one to several at a time lasting several weeks. They had not res...
Welcome back to the new look PCDS website, and our first case. This lady was referred as a 2-week wait with a changing lesion on the right temple.
A 15 year old lady was referred for a diagnostic opinion for skin changes presenting in birth, affecting the right upper back, shoulder, antecubital fossa and dorsal wrist. The patient was asymptomatic and otherwise well.
The following pharmaceutical companies have had no involvement in the content of this website or in our conference programmes
