Sunday, October 28, 2007

Verrucous plaques



This 48-year-old woman presented with several year history of developing multiple well demarcated excoriated pruritic verrucous plaques on the dorsa of the feet and lower legs. The plaques would intermittently get secondarily infected oozing a purulent exudate. Non-pitting edema of the right foot was also evident. What would be the differential dignosis?

6 comments:

Dr. Shahbaz A.Janjua said...

Prof Norman Levine responded:
I think that this is lichen simplex chronicus, perhaps with secondary infection. The diff dx would include very inflammatory psoriasis, infectious granulomas (deep fungal infection, etc), hyertrophic LP and LE.

Dr Ian McColl said...

The weeping and oozing would suggest a dermatitic process that has been lichenified by constant rubbing. The pigmentation and site would make me consider hypertrophic lichen planus but the weeping is not seen in that condition.
Best wishes

Jayakar Thomas said...

It looks like hypertrophic lichen planus

Dr. Shahbaz A.Janjua said...

The differential diagnosis includes lichen simplex chronicus, hypertrophic lichen planus, TVC, and chromoblastomycosis.
Dr. Khalid Jameel, FCPS
Dermatologist, Kharian.

Dr. Shahbaz A.Janjua said...

The differential diagnosis includes lichen simplex chronicus, hypertrophic lichen planus, TVC, and chromoblastomycosis.
Dr. Khalid Jameel, FCPS
Dermatologist, Kharian.

Dr. Khalid Jameel said...

The differential diagnosis includes lichen simplex chronicus, hypertrophic lichen planus, TVC, and chromoblastomycosis.