Clinical Geriatrics

A 71-year-old man presented to the office because of dry skin. He said that since he was a child, he always had flaky, dry skin that covered almost his entire body. Although he had been prescribed many types of lotions and ointments during his lifetime, none relieved nor worsened his dry skin. The patient reported no redness or pruritus. To his knowledge, there was no family history of anyone having the same symptoms. The man had a 59-pack-year history of smoking and his medical history included basal cell carcinoma, hypertension, and peripheral arterial disease, for which he had undergone peripheral arterial bypass surgery. Upon physical examination, he had dry, flesh-colored, polygonal scales covering his entire body, particularly on his arms and legs (Figures). At the time, he was using prescribed desonide topical lotion, mupirocin topical ointment, and urea topical cream. He was also taking clopidogrel to prevent blood clots.Based on the photographs and the case description, what is your diagnosis? 

Based on the photographs and the case description, what is your diagnosis? 

A. Asteatotic eczema                   C. Ichthyosis vulgaris

B. Lichen simplex chronicus       D. Contact dermatitis