What Is Your Diagnosis Of This Skin Condition?

How would you diagnose the skin condition in the left photo?

This condition is more common in the aging population but it can also occur due to: environmental conditions such as low humidity in the winter; medications; endocrine disorders such as diabetes and hyperthyroidism; after infection (post-cellulitis desquamation); and with renal dysfunction, especially for patients who are undergoing dialysis.

In general, when determining the diagnosis of a plantar dry scaly rash, a simple KOH can be useful. When this particular condition presents, it will be KOH-negative for dermatophytes. A severe manifestation of this condition is characterized by marked scale and early fissure formation as shown in the photo.

Which of the following is your diagnosis?

a. Moccasin tinea pedis

b. Ichthyosis

c. Keratoderma climactericum

d. Severe xerosis

Editor’s note: This blog is adapted from the handbook, Skin Disease Of The Lower Extremities: A Photographic Guide, from Tracey Vlahovic, DPM, and Stephen M. Schleicher, MD. The book is available for purchase at www.lowerextremityderm.com . The e-book version is available for purchase at https://tinyurl.com/7itt66v , https://tinyurl.com/7j44vez and https://tinyurl.com/couepf5 .