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Summer 2017, Vol. 25 No. 2

Hong Kong J. Dermatol. Venereol. (2017) 25, 95-96


Dermato-venereological Quiz

Dermato-venereological Quiz

SM Wong 黃思敏 and W Cheuk 卓華

A 53-year-old gentleman presented with a 4-month history of itchiness, skin fragility and blisters over bilateral dorsal hands and forearms. He was a construction site worker. He reported that the lesions became worse after sun exposure. On examination, there were tiny blisters, milia and scarring found over the dorsum of both hands (Figure.1). Skin biopsy of the intact blister was performed (Figures 2 & 3).

Figure 1 Single blister on the side of the hand. Milia and scarring were also noted.

Figure 2 (a) 100x, H&E; (b) 200x, H&E.

Figure 3 200x, PAS.

Questions

1. What is the diagnosis and differential diagnosis?

2. What history would you like to ask this gentleman?

3. What investigations will you order?

4. What test can be performed in your office?

5. What is your management?