Advertisement

Elderly patient of Crohn's disease with dementia and edematous red plaques on dorsum of hands

  • Amit Dalla
    Affiliations
    Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
    Search for articles by this author
  • Sheetanshu Kumar
    Affiliations
    Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
    Search for articles by this author
  • Dipankar De
    Correspondence
    Corresponding author at: Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh 160012, India.
    Affiliations
    Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
    Search for articles by this author
      An elderly man sought dermatology consultation for gradually progressive, mildly itchy, photosensitive rash on dorsum of hands for a month. Apart from the skin lesions, he also complained of intermittent diarrhoea which he attributed to his underlying Crohn's disease. He additionally had difficulty in recalling recent events for last few months. On examination (Fig. 1), well demarcated erythematous to dusky edematous plaques were noted symmetrically on dorsal aspect of hands and fingers. Skin of no other part was involved. Lesional skin biopsy demonstrated epidermal spongiosis, elongation of rete ridges, hyaline degeneration of collagen and mild perivascular lymphocytic infiltrate in dermis. What is your diagnosis?
      Fig. 1
      Fig. 1a: Well demarcated erythematous to dusky edematous plaques distributed symmetrically on dorsal aspect of hands and fingers. b: Complete clearance of lesions at 12 weeks after niacin supplementation

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to European Journal of Internal Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Hegyi J.
        • Schwartz R.A.
        • Hegyi V.
        Pellagra: dermatitis, dementia, and diarrhea.
        Int J Dermatol. 2004; 43: 1-5
        • Zaki I.
        • Millard L.
        Pellagra complicating Crohn's disease.
        Postgrad Med J. 1995; 71: 496-497
        • Karthikeyan K.
        • Thappa D.M.
        Pellagra and skin.
        Int J Dermatol. 2002; 41: 476-481