A 72-year-old man presents in winter with intense itching over both shins. Examination shows dry skin with a cracked, crazy-pavement appearance resembling cracked porcelain or a dried riverbed. What is the diagnosis?

• A Nummular eczema
• B Lichen simplex chronicus
• C Stasis dermatitis
• D Asteatotic eczema (eczema craquele) ✓

Explanation

Asteatotic eczema occurs in elderly patients on dry, low-humidity skin, classically the shins in winter, with a characteristic cracked, tile-like or crazy-pavement surface called eczema craquele. Low humidity, hot baths, and diuretics aggravate it. Nummular eczema produces discrete coin-shaped plaques rather than a fine crackled network, which distinguishes it from this presentation.

Reference: Fitzpatrick's Dermatology, 9th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.