A rare and difficult-to-treat skin condition

Skin Deep: How to identify and treat this rare chronic kyperkeratotic rash.

THIS is a rare, reddish brown, non-itchy, hyperkeratotic rash localised to the thighs and forearms with genital ulceration and a mild seborrhoeic dermatitis rash on the face. Looking carefully at the keratotic papules you will see that some are in lines or a reticular pattern. This is Nekam’s disease or keratosis lichenoides chronica.

In the world literature, there are only about 75 cases. It is the first example I have seen in 30 years’ practice,