Red and scaly nearly all over

Case presentation

A 67-YEAR-OLD woman gave a three-month history of red, scaly, flaking skin. She had no previous skin diseases, and her only medical condition was hypertension, which was controlled with medication. 

Examination revealed widespread non-pruritic erythematous scaly patches with some uninvolved skin on the trunk (Figures 1, 2). There were thick, yellow plaques on the palms and soles, as well as yellow discolouration of her nails, with subungual hyperkeratosis (Figure 3). Ectropion was present with no mucous membrane involvement.

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