A 71 Year old Male with a Widespread Rash

You are providing a domiciliary care service to a local old people’s home. One of your patients is a
71 year old gentleman who complains of a rash involving his legs, back and buttocks.

Around the edges of the rash there are some scattered satellite pustules and papules. There are
some erosions in areas of the rash where the skin is raw and oozing.

On taking his medical history, you establish that the patient has a 20 year history of Type 2
diabetes and has been using steroids for 19 years to manage chronic obstructive pulmonary disease.

Based on the case description provided consider your preferred differential diagnosis. Consider
the following conditions in arriving at your diagnosis:

1) Eczema
2) Tinea corporis
3) Psoriasis
4) Cellulitis
5) Candidiasis

Justify your selected differential diagnosis based on the case (and your growing knowledge of the
fundamentals of dermatology) and consider whether special examinations are required to aid in
arriving at your diagnosis (for e.g. microbiology, biopsy, etc). Discuss how the management of your
preferred differential diagnosis.
 A 70 year old male with very dry skin

A 70 year old male attends your clinic complaining of very dry skin that he has had for a long time.
He tells you that over the past year it has worsened. He has bought over-the-counter moisturisers
that have helped somewhat, but it has really not helped to ease the dryness and pruritis he
experiences.

Based on the above information, what is your preferred diagnosis? How will you manage the
condition on the basis of your diagnosis? Consider the following potential conditions:

1) Numular eczema
2) Stasis eczema
3) Ichthyosis vulgaris
4) Xerosis

In arriving at your preferred diagnosis, ensure that you clearly articulate the bases for being able
to rule out the differential diagnoses.