A 65-year-old male presented to a dermatologist with the complaints of mildly pruritic and erythematous plaques distributed in a generalized fashion on his hands ( Fig. 1 ). Three weeks ago, the patient had noticed the eruption on his face, distal arms, and trunk; however, the eruptions recently started to affect his hands (Fig. 2).
The patient had no history of eczema or psoriasis. Furthermore, he was not on any regular medication. Physical examination Presence of erythroderma on extensor surfaces and gluteal cleft Absence of any rash Thickening and scaling of the skin over his palms with some orange discoloration Histological examination (hematoxylin and eosin staining) Alternating orthokeratosis and parakeratosis Presence of acanthosis and psoriasiform hyperplasia in the epidermis Presence of sparse mixed infiltrate Follicular plugging with parakeratosis at the edge of the follicular…
