Case history
Case history #1
A 4-year-old boy is brought to the office by his parents with the complaint of dry skin. The dry skin has been present since the child was about 1 year old, and is worse during the winter months and on the lower extremities. The skin on the lower extremities is extremely rough and occasionally will become cracked. His dry skin has been treated with multiple moisturizing creams with only minimal improvement. The boy has a history of asthma but is otherwise healthy. On physical exam, he has fine scaling of the skin over his trunk and extremities, with large scales present bilaterally on his lower legs. He also has hyperlinear palms and fine, hyperkeratotic papules present on the upper lateral arms.
Case history #2
A previously healthy 56-year-old man presents with the sudden onset of widespread scaling and palmar hyperkeratosis. The patient also reports recent weight loss, abdominal pain, and night sweats. On physical exam, in addition to the presenting complaints, the patient is noted to have bilateral axillary lymphadenopathy.
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