Hong Kong J. Dermatol. Venereol. (2016) 24, 155-156

A middle-aged Chinese woman presented with6-month history of an itchy skin rash. She hadunderlying hypertension, diabetes mellitus,obesity, chronic kidney disease and history ofcolonic cancer with resection done 10 yearspreviously. The eruption occurred on the shins,the trunk and the back. There was no historyof insect bites or use of new medications.Examination revealed multiple erythematousround papules and papulonodules with a keratoticcentre (Figure 1). She was otherwise afebrile andclinically well. A punch skin biopsy was obtainedon the leg for histological evaluation (Figures 2a& 2b).

Dermato-venereological Quiz

CMT Cheung , MM Chang , PCL Choi

Division of Dermatology, Department of MedicineDivision of Dermatology, Department of MedicineDivision of Dermatology, Department of MedicineDivision of Dermatology, Department of MedicineDivision of Dermatology, Department of Medicine& Therapeutics, Prince of W& Therapeutics, Prince of W& Therapeutics, Prince of W& Therapeutics, Prince of W& Therapeutics, Prince of Wales Hospital, Hong Kongales Hospital, Hong Kongales Hospital, Hong Kongales Hospital, Hong Kongales Hospital, Hong Kong

CMT Cheung, MBChB, MRCPMM Chang, MBChB, FHKCP

Department of Anatomical and Cellular PDepartment of Anatomical and Cellular PDepartment of Anatomical and Cellular PDepartment of Anatomical and Cellular PDepartment of Anatomical and Cellular Pathologyathologyathologyathologyathology,,,,,Prince of WPrince of WPrince of WPrince of WPrince of Wales Hospital, Hong Kongales Hospital, Hong Kongales Hospital, Hong Kongales Hospital, Hong Kongales Hospital, Hong Kong

PCL Choi, MBChB, FRCPA

Correspondence to: Dr. CMT Cheung

9/F, Clinical Sciences Building, Department of Medicine andTherapeutics, Prince of Wales Hospital, 30-32 Ngan ShingStreet, Shatin, New Territories, Hong Kong

Figure 1.Figure 1.Figure 1.Figure 1.Figure 1.

Dermato-venereological quiz156

Figure 2. Figure 2. Figure 2. Figure 2. Figure 2. Skin biopsy. Haematoxylin & eosin stain, magnification x100 (a) and x200 (b).

QuestionsQuestionsQuestionsQuestionsQuestions

1. What are the differential diagnoses?2. What does the biopsy show?3. What is the diagnosis?4. What is the treatment?

(a)(a)(a)(a)(a) (b)(b)(b)(b)(b)

(Answers on page 167)