Arms and Legs Red Scaly

Psoriasis

Solar keratoses and Scc

 

Red scaly lesions on the arms and legs

The commonest red scaly rashes in these areas are the classic diseases in dermatology namely psoriasis,eczema,tinea corporis and discoid lupus erythematosus.Then you would consider subacute lupus erythematosus,parapsoriasis,pityriasis rubra pilaris,pityriasis lichenoides,early mycosis fungoides.In white populations sun damage is very common with solar keratoses,superficial Bccs and Scc insitu all causing red scaly lesions.Porokeratoses are another manifestation of sun damage seen on exposed areas of the arms and legs.

Management    Take a skin scraping to exclude fungus.Look at other areas of the body to confirm psoriasis.Check the scalp and the palms for other features of Pityriasis rubra pilaris and also for the characteristic follicular papules particularly on the back of the hands. Look for the inward facing scale of Pityriasis rosea particularly in the groin and axillary areas.Look for the cracked oozing skin of eczema.Do bloods to look for lupus antibodies and do a skin biopsy for the rest.

SIGN DIP MEN     Overview of Red scaly diseases

 

S-Squamous      Psoriasis,Atopic eczema,Contact eczema,Seborrhoeic eczema,Pityriasis rosea,Pityriasis lichenoides,Pityriasis versicolor,Pityriasis rubra pilaris,Darier’s disease,Lichen planus,Erythrokeratoderma,Exfoliative dermatitis,Congenital ichthyosiform erythroderma,Lamellar ichthyosis,Epidermolytic hyperkeratosis,

 

I-Infective     Tinea corporis,Secondary syphilis,Tuberculosis,Leprosy,Leishmaniasis,Candidiasis

 

G-Granulomatous  Sarcoidosis 

 

N-Neoplastic    Superficial bcc and scc,Parapsoriasis,Mycosis fungoides,Sezary syndrome,Disseminated actinic porokeratoses,

 

D-Drugs  Exfoliative dermatitis eg gold,

 

I-Immunological   Discoid lupus erythematosus,Pemphigus foliaceous,Chronic actinic dermatitis

 

P-Physical     Sunburn,Scabies,Perforating disorders,

 

M-Metabolic  Glucagonoma syndrome,

 

E-Endocrine   

 

N-Nutritional      Pellagra, Acrodermatitis enteropathica,Kwashiokor,

 

Others   Ilven,